Author: "Gojka Roglic" - Searchworks@Jio Institute Digital Library Search Results

47 results on '"Gojka Roglic"'

1. Development of a target product profile for a point-of-care cardiometabolic device

Author: Beatrice Vetter, David Beran, Philippa Boulle, Arlene Chua, Roberto de la Tour, Lucy Hattingh, Pablo Perel, Gojka Roglic, Rangarajan Sampath, Michael Woodman, and Sigiriya Aebischer Perone
Subjects: Cardiovascular disease, Diabetes, In vitro diagnostics, Medical device, Low- and middle-income country, Primary care, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Abstract Introduction Multi-parameter diagnostic devices can simplify cardiometabolic disease diagnosis. However, existing devices may not be suitable for use in low-resource settings, where the burden of non-communicable diseases is high. Here we describe the development of a target product profile (TPP) for a point-of-care multi-parameter device for detection of biomarkers for cardiovascular disease and metabolic disorders, including diabetes, in primary care settings in low- and middle-income countries (LMICs). Methods A draft TPP developed by an expert group was reviewed through an online survey and semi-structured expert interviews to identify device characteristics requiring refinement. The draft TPP included 41 characteristics with minimal and optimal requirements; characteristics with an agreement level for either requirement of ≤ 85% in either the survey or among interviewees were further discussed by the expert group and amended as appropriate. Results Twenty people responded to the online survey and 18 experts participated in the interviews. Twenty-two characteristics had an agreement level of ≤ 85% in either the online survey or interviews. The final TPP defines the device as intended to be used for basic diagnosis and management of cardiometabolic disorders (lipids, glucose, HbA1c, and creatinine) as minimal requirement, and offering an expanded test menu for wider cardiometabolic disease management as optimal requirement. To be suitable, the device should be intended for level 1 healthcare settings or lower, used by minimally trained healthcare workers and allow testing using self-contained cartridges or strips without the need for additional reagents. Throughput should be one sample at a time in a single or multi-analyte cartridge, or optimally enable testing of several samples and analytes in parallel with random access. Conclusion This TPP will inform developers of cardiometabolic multi-parameter devices for LMIC settings, and will support decision makers in the evaluation of existing and future devices.
Published: 2021
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2. WHO Global report on diabetes: A summary

Author: Gojka Roglic
Subjects: Diabetes, global report, WHO, Specialties of internal medicine, RC581-951
Abstract: The first WHO Global Report on Diabetes was launched on World Health Day 7 th April 2016 which was dedicated to Diabetes (1). Diabetes has been described in ancient scripts and recognized as a serious illness, but it does not appear to have been frequently encountered by physicians or healers. It is in the past few decades that human health and development is increasingly affected by the rising numbers of people with this condition. Diabetes, together with cardiovascular disease, cancer and chronic respiratory disease has been targeted in the Political Declaration on the Prevention and Control of Noncommunicable Diseases (NCDs) at the Un High-level Political Meeting in 2011. In 2013 WHO member states endorsed a global monitoring framework for noncommunicable diseases, with 9 targets to be reached by 2025. Diabetes and its key risk factors are strongly reflected in the targets and indicators - reduction of exposure to unhealthy diet and physical inactivity, zero rise in the prevalence of diabetes, improved access to treatment and reduction of premature mortality. As part of the 2030 Agenda for Sustainable Development, Member States have set an ambitious target to reduce premature mortality from NCDs - including diabetes - by one third; achieve universal health coverage; and provide access to affordable essential medicines - all by 2030( http://www.un.org/sustainabledevelopment/sustainable-development-goals/).
Published: 2016
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3. Nutrition, diabetes and tuberculosis in the epidemiological transition.

Author: Christopher Dye, Bernadette Bourdin Trunz, Knut Lönnroth, Gojka Roglic, and Brian G Williams
Subjects: Medicine, Science
Abstract: BACKGROUND: Diabetes prevalence and body mass index reflect the nutritional profile of populations but have opposing effects on tuberculosis risk. Interactions between diabetes and BMI could help or hinder TB control in growing, aging, urbanizing populations. METHODS AND FINDINGS: We compiled data describing temporal changes in BMI, diabetes prevalence and population age structure in rural and urban areas for men and women in countries with high (India) and low (Rep. Korea) TB burdens. Using published data on the risks of TB associated with these factors, we calculated expected changes in TB incidence between 1998 and 2008. In India, TB incidence cases would have increased (28% from 1.7 m to 2.1 m) faster than population size (22%) because of adverse effects of aging, urbanization, changing BMI and rising diabetes prevalence, generating an increase in TB incidence per capita of 5.5% in 10 years. In India, general nutritional improvements were offset by a fall in BMI among the majority of men who live in rural areas. The growing prevalence of diabetes in India increased the annual number of TB cases in people with diabetes by 46% between 1998 and 2008. In Korea, by contrast, the number of TB cases increased more slowly (6.1% from 40,200 to 42,800) than population size (14%) because of positive effects of urbanization, increasing BMI and falling diabetes prevalence. Consequently, TB incidence per capita fell by 7.8% in 10 years. Rapid population aging was the most significant adverse effect in Korea. CONCLUSIONS: Nutritional and demographic changes had stronger adverse effects on TB in high-incidence India than in lower-incidence Korea. The unfavourable effects in both countries can be overcome by early drug treatment but, if left unchecked, could lead to an accelerating rise in TB incidence. The prevention and management of risk factors for TB would reinforce TB control by chemotherapy.
Published: 2011
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4. Improving health outcomes of people with diabetes: target setting for the WHO Global Diabetes Compact

Author: Edward W Gregg, James Buckley, Mohammed K Ali, Justine Davies, David Flood, Roopa Mehta, Ben Griffiths, Lee-Ling Lim, Jennifer Manne-Goehler, Jonathan Pearson-Stuttard, Nikhil Tandon, Gojka Roglic, Slim Slama, Jonathan E Shaw, Kokou Agoudavi, Krishna K. Aryal, Rifat Atun, Silver Bahendeka, Brice Wilfried Bicaba, Pascal Bovet, Garry Brian, Albertino Damasceno, Justine I. Davies, Maria Dorobantu, Farshad Farzadfar, Pascal Geldsetzer, Mongal Singh Gurung, David Guwatudde, Corine Houehanou, Dismand Houinato, Nahla Hwalla, Lindsay Jaacks, Bahadur Khem Karki, Demetre Labadarios, Nuno Lunet, Maja E. Marcus, Joao Martins, Theodory Mary Mayige, Bolormaa Norov, Sahar Saeedi Moghaddam, Sarah Quesnel-Crooks, Abla M. Sibai, Lela Sturua, Michaela Theilmann, Lindiwe Tsabedze, Sebastian Vollmer, and Zhaxybay Zhumadilov
Subjects: General Medicine
Published: 2023
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5. Development of a target product profile for a point-of-care cardiometabolic device

Author: Sigiriya Aebischer Perone, Michael Woodman, Gojka Roglic, Roberto de la Tour, David Beran, Pablo Perel, Lucy Hattingh, Arlene Chua, Philippa Boulle, Rangarajan Sampath, and Beatrice N. Vetter
Subjects: Blood Glucose, Consensus, Delphi Technique, Point-of-Care Systems, Sample (statistics), Primary care, Disease, Low- and middle-income country, Predictive Value of Tests, Health care, Materials Testing, Diabetes Mellitus, Medicine, Diseases of the circulatory (Cardiovascular) system, Humans, Point of care, Medical device, Reagent Strips, Glycated Hemoglobin, Metabolic Syndrome, Primary Health Care, business.industry, Research, Product profile, Diabetes, Equipment Design, medicine.disease, Cardiovascular disease, Lipids, Test (assessment), Multi-parameter device, Cardiovascular Diseases, Point-of-Care Testing, RC666-701, Creatinine, Medical emergency, Cardiology and Cardiovascular Medicine, business, Random access, Biomarkers, Blood Chemical Analysis, In vitro diagnostics
Abstract: Introduction Multi-parameter diagnostic devices can simplify cardiometabolic disease diagnosis. However, existing devices may not be suitable for use in low-resource settings, where the burden of non-communicable diseases is high. Here we describe the development of a target product profile (TPP) for a point-of-care multi-parameter device for detection of biomarkers for cardiovascular disease and metabolic disorders, including diabetes, in primary care settings in low- and middle-income countries (LMICs). Methods A draft TPP developed by an expert group was reviewed through an online survey and semi-structured expert interviews to identify device characteristics requiring refinement. The draft TPP included 41 characteristics with minimal and optimal requirements; characteristics with an agreement level for either requirement of ≤ 85% in either the survey or among interviewees were further discussed by the expert group and amended as appropriate. Results Twenty people responded to the online survey and 18 experts participated in the interviews. Twenty-two characteristics had an agreement level of ≤ 85% in either the online survey or interviews. The final TPP defines the device as intended to be used for basic diagnosis and management of cardiometabolic disorders (lipids, glucose, HbA1c, and creatinine) as minimal requirement, and offering an expanded test menu for wider cardiometabolic disease management as optimal requirement. To be suitable, the device should be intended for level 1 healthcare settings or lower, used by minimally trained healthcare workers and allow testing using self-contained cartridges or strips without the need for additional reagents. Throughput should be one sample at a time in a single or multi-analyte cartridge, or optimally enable testing of several samples and analytes in parallel with random access. Conclusion This TPP will inform developers of cardiometabolic multi-parameter devices for LMIC settings, and will support decision makers in the evaluation of existing and future devices.
Published: 2021

6. Type 1 Diabetes in 2017 - Global Estimates of Incident and Prevalent Cases in Children and Adults

Author: Gojka Roglic, Simone Møller Hede, Sarah H Wild, Anders Green, David Henry Beran, Christopher Patterson, and Giuseppina Imperatore
Subjects: Adult, medicine.medical_specialty, Epidemiology, Endocrinology, Diabetes and Metabolism, Population, Declaration, Global estimates, Global Health, Adult age, Article, SDG 3 - Good Health and Well-being, Diabetes mellitus, Health care, Internal Medicine, Prevalence, Humans, Adults, Medicine, Child, education, Children, education.field_of_study, Type 1 diabetes, business.industry, Applied economics, Mortality rate, Incidence, Incidence (epidemiology), Infant, Newborn, medicine.disease, Diabetes Mellitus, Type 1, Income, Estimation methods, business, Demography
Abstract: Aims/hypothesis Data on type 1 diabetes incidence and prevalence are limited, particularly for adults. This study aims to estimate global numbers of incident and prevalent cases of type 1 diabetes in 2017 for all age groups, by country and areas defined by income and region. Methods Incidence rates of type 1 diabetes in children (available from 94 countries) from the IDF Atlas were used and extrapolated to countries without data. Age-specific incidence rates in adults (only known across full age range for fewer than ten countries) were obtained by applying scaling ratios for each adult age group relative to the incidence rate in children. Age-specific incidence rates were applied to population estimates to obtain incident case numbers. Duration of diabetes was estimated from available data and adjusted using differences in childhood mortality rate between countries from United Nations demographic data. Prevalent case numbers were derived by modelling the relationship between prevalence, incidence and disease duration. Sensitivity analyses were performed to quantify the impact of alternative assumptions and model inputs. Results Global numbers of incident and prevalent cases of type 1 diabetes were estimated to be 234,710 and 9,004,610, respectively, in 2017. High-income countries, with 17% of the global population, accounted for 49% of global incident cases and 52% of prevalent cases. Asia, which has the largest proportion of the world’s population (60%), had the largest number of incident (32%) and prevalent (31%) cases of type 1 diabetes. Globally, 6%, 35%, 43% and 16% of prevalent cases were in the age groups 0–14, 15–39, 40–64 and 65+ years, respectively. Based on sensitivity analyses, the estimates could deviate by ±15%. Conclusions/interpretation Globally, type 1 diabetes represents about 2% of the estimated total cases of diabetes, ranging from less than 1% in certain Pacific countries to more than 15% in Northern European populations in 2017. This study provides information for the development of healthcare and policy approaches to manage type 1 diabetes. The estimates need further validation due to limitations and assumptions related to data availability and estimation methods. Graphical abstract
Published: 2020
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7. Care of non-communicable diseases in emergencies

Author: S. Rasheed, Philippa Boulle, Hyo-Jeong Kim, Marcello Tonelli, Heiko Hering, Cherian Varghese, Gojka Roglic, and Slim Slama
Subjects: Emergency Medical Services, medicine.medical_specialty, Inclusion (disability rights), Refugee, Disease, Phase (combat), 03 medical and health sciences, 0302 clinical medicine, medicine, Emergency medical services, Humans, 030212 general & internal medicine, Natural disaster, Intensive care medicine, business.industry, 030503 health policy & services, Relief Work, General Medicine, Continuity of Patient Care, medicine.disease, Preparedness, Chronic Disease, Medical emergency, Emergencies, 0305 other medical science, business
Abstract: Introduction Emergencies include natural disasters such as earthquakes and severe meteorological events, but also armed confl ict and its consequences, such as civil disruption and refugee crises (sometimes termed chronic emergencies). The health component of the humanitarian response to emergencies has traditionally focused on management of acute conditions such as trauma and infectious illnesses. However, noncommunicable diseases (NCDs) such as diabetes, hypertension, cardiovascular disease, cancer, and chronic lung disease are now leading causes of disability and death in low-income and middle-income countries (LMICs) and disaster-prone areas. NCDs require ongoing management for optimal outcomes, which is challenging in emergency settings because natural disasters or confl icts increase the risk of acute NCD exacerbations and decrease the ability of health systems to respond. Also, complex emergencies compromise NCD prevention and control over a prolonged period; limited access to timely treatment can lead to poor outcomes for patients and impose the high costs of managing complications on humanitarian agencies. Therefore, a more comprehensive approach to NCD management in emergencies is an important but neglected aspect of humanitarian response. Management of NCDs in emergencies requires inclusion of NCD care into standard operating procedures, which would facilitate horizontal and vertical integration with other aspects of relief eff orts. Humanitarian response in emergencies can be divided into three phases: mitigation and preparedness, emergency response, and post-emergency phase. Existing guidance for humanitarian response identifi es certain NCD-relevant considerations, but these chiefl y refer to the emergency response phase and are limited in scope. Here we propose the content of a minimally adequate response to NCDs in emergencies. This Viewpoint proposes specifi c actions organised by phase of the humanitarian response (fi gure), as well as some potential indicators for assessment of progress. We selected actions for inclusion based on their potential to reduce morbidity and mortality while minimising administrative and logistical burden for humanitarian responders. Where possible, we have prioritised actions that align with existing eff orts to strengthen NCD care.
Published: 2017
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8. Implications of the growing burden of diabetes for premature cardiovascular disease mortality and the attainment of the Sustainable Development Goal target 3.4

Author: Nigel Unwin, Yadi Huang, Constance Wou, and Gojka Roglic
Subjects: Sustainable development, business.industry, Disease mortality, Diabetes prevalence, Disease, Review Article, 030204 cardiovascular system & hematology, medicine.disease, World health, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, Environmental health, Medicine, 030212 general & internal medicine, Risk factor, Cardiology and Cardiovascular Medicine, business, Health policy
Abstract: Non-communicable diseases (NCDs) are a major cause of deaths globally, and cardiovascular disease (CVD) is the leading cause of these deaths. 42% of NCD deaths are premature (occurring before the age of 70 years). As part of the United Nations 3rd Sustainable Development Goal (SDG) on health and wellbeing, target 3.4 is to reduce premature mortality from NCDs by one third between 2015 and 2030. This target adds to the World Health Organization (WHO) target of reducing premature deaths from NCDs by 25% between 2010 and 2025. As diabetes is a major risk factor for CVD, it is important to account for the trends in diabetes when considering premature CVD mortality. We aimed to describe the global trends in diabetes prevalence and mortality, critically review the literature on the estimated attainability of the WHO and SDG targets, and determine if and how these studies accounted for trends in diabetes. Worldwide, the prevalence of diabetes is rising, with an estimated 9.0% global prevalence in adults aged 20–69 by 2030, and low- and middle-income countries (LMICs) having the largest increase of the burden in absolute numbers and age-standardized prevalence. There is a lack of data from most LMICs on the excess CVD mortality associated with diabetes and therefore no consensus on the global risk of CVD mortality in people with diabetes. Where data do exist, there are discrepancies between studies on the direction of mortality trends from diabetes over time. We reviewed 12 studies that estimated the attainability of the WHO or SDG targets for premature NCD mortality. Seven of these considered the potential impacts of achieving the 2025 WHO risk factor targets. Six studies modelled the impact of current trends in risk factors, including diabetes, continuing toward the target dates. Four studies compared this ‘business as usual’ model with the attainment of the risk factor targets for the world as whole and individual regions, 2 studies for NCD mortality overall, and 2 specifically for CVD mortality. On the impact of diabetes with regards to attainment of the WHO or SDG targets for premature CVD mortality, the overall results were inconclusive. Some concluded that none of the countries or regions considered would meet the targets, and others predicted that in some areas, the targets would be met. Examining the potential impact of trends in diabetes on future CVD mortality rates in LMICs is limited by a relative lack of high quality studies, including on the age specific excess mortality associated with diabetes. Filling these data gaps will enable better estimates of the potential impacts on future CVD mortality of the rapidly increasing prevalence of diabetes in LMICs and help to better inform health policy and the attainment of SDG target 3.4.
Published: 2019

9. Morbidity and mortality after lifestyle intervention for people with impaired glucose tolerance: 30-year results of the Da Qing Diabetes Prevention Outcome Study

Author: Qiuhong Gong, Ping Zhang, Jinping Wang, Jixiang Ma, Yali An, Yanyan Chen, Bo Zhang, Xinxing Feng, Hui Li, Xiaoping Chen, Yiling J Cheng, Edward W Gregg, Yinghua Hu, Peter H Bennett, Guangwei Li, Xin Qian, Lihong Zhang, Yuanchi Hui, Siyao He, Xuan Wang, Theodore J. Thompson, Robert B. Gerzoff, Pingan Liu, Yayun Jiang, Zexi Hu, Jixing Wang, Xigui Jiang, Jingling Zhang, Ruimin Xi, Chengyan Pang, Chunqin Li, Xiuying Hu, Wenying Yang, Zuoxin An, Xinquan Sun, Chuan Chen, Yong Gang, Juan Liu, Jianzhong Xiao, Huibi Cao, Hui Zheng, Hui Zhang, Hongliang Li, Jing Hong, Xueli Liu, Fang Zhao, Wenjuan Wang, Bo Chen, Barbara V. Howard, Michael M. Engelgau, Gojka Roglic, and The Royal Society
Subjects: Pediatrics, medicine.medical_specialty, METFORMIN, Endocrinology, Diabetes and Metabolism, Psychological intervention, 030209 endocrinology & metabolism, Type 2 diabetes, Disease, Article, Impaired glucose tolerance, Endocrinology & Metabolism, MELLITUS, 03 medical and health sciences, NIDDM, 0302 clinical medicine, Endocrinology, Diabetes mellitus, Internal Medicine, Medicine, 030212 general & internal medicine, Science & Technology, business.industry, Incidence (epidemiology), Hazard ratio, Da Qing Diabetes Prevention Study Group, medicine.disease, REDUCTION, Life expectancy, FOLLOW-UP, business, Life Sciences & Biomedicine
Abstract: Summary Background Lifestyle interventions can delay the onset of type 2 diabetes in people with impaired glucose tolerance, but whether this leads subsequently to fewer complications or to increased longevity is uncertain. We aimed to assess the long-term effects of lifestyle interventions in people with impaired glucose tolerance on the incidence of diabetes, its complications, and mortality. Methods The original study was a cluster randomised trial, started in 1986, in which 33 clinics in Da Qing, China, were randomly assigned to either be a control clinic or provide one of three interventions (diet, exercise, or diet plus exercise) for 6 years for 577 adults with impaired glucose tolerance who usually receive their medical care from the clinics. Subsequently, participants were followed for up to 30 years to assess the effects of intervention on the incidence of diabetes, cardiovascular disease events, composite microvascular complications, cardiovascular disease death, all-cause mortality, and life expectancy. Findings Of the 577 participants, 438 were assigned to an intervention group and 138 to the control group (one refused baseline examination). After 30 years of follow-up, 540 (94%) of 576 participants were assessed for outcomes (135 in the control group, 405 in the intervention group). During the 30-year follow-up, compared with control, the combined intervention group had a median delay in diabetes onset of 3·96 years (95% CI 1·25 to 6·67; p=0·0042), fewer cardiovascular disease events (hazard ratio 0·74, 95% CI 0·59–0·92; p=0·0060), a lower incidence of microvascular complications (0·65, 0·45–0·95; p=0·025), fewer cardiovascular disease deaths (0·67, 0·48–0·94; p=0·022), fewer all-cause deaths (0·74, 0·61–0·89; p=0·0015), and an average increase in life expectancy of 1·44 years (95% CI 0·20–2·68; p=0·023). Interpretation Lifestyle intervention in people with impaired glucose tolerance delayed the onset of type 2 diabetes and reduced the incidence of cardiovascular events, microvascular complications, and cardiovascular and all-cause mortality, and increased life expectancy. These findings provide strong justification to continue to implement and expand the use of such interventions to curb the global epidemic of type 2 diabetes and its consequences. Funding US Centers for Disease Control and Prevention, WHO, Chinese Center for Disease Control and Prevention, World Bank, Ministry of Public Health of the People's Republic of China, Da Qing First Hospital, China–Japan Friendship Hospital, and National Center for Cardiovascular Diseases & Fuwai Hospital.
Published: 2019

10. Diagnosis of GDM: A suggested consensus

Author: Harold David McIntyre, Gojka Roglic, Stephen Colagiuri, and Moshe Hod
Subjects: medicine.medical_specialty, Study groups, Consensus, endocrine system diseases, World health, Pregnancy, Diabetes mellitus, medicine, Humans, Developing Countries, Randomized Controlled Trials as Topic, Gynecology, American diabetes association, business.industry, Pregnancy Outcome, nutritional and metabolic diseases, Obstetrics and Gynecology, General Medicine, medicine.disease, female genital diseases and pregnancy complications, Gestational diabetes, Diabetes, Gestational, Family medicine, Female, business
Abstract: Despite recent attempts at building consensus, an internationally consistent definition of gestational diabetes mellitus (GDM) remains elusive. Within and between countries, there is disagreement between obstetric, medical, and endocrine groups as to the diagnosis and management of GDM. The current article aims to discuss the background to the controversy of GDM diagnosis and to address issues related to the detection and treatment of GDM in low-, middle-, and high-resource settings. The criteria recommended by the International Association of the Diabetes and Pregnancy Study Groups (IADPSG), the American Diabetes Association (ADA), and the World Health Organization (WHO) are endorsed. We also wish to put into perspective the importance of GDM, both during and after pregnancy, in terms of its relationship to overall women's health.
Published: 2015
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11. Cardiovascular mortality, all-cause mortality, and diabetes incidence after lifestyle intervention for people with impaired glucose tolerance in the Da Qing Diabetes Prevention Study: a 23-year follow-up study

Author: Wenying Yang, Michael M. Engelgau, Ping Zhang, Peter H. Bennett, Yinghua Hu, Gojka Roglic, Edward W. Gregg, Yali An, Jing Hong, Ying Shuai, Qiuhong Gong, Guangwei Li, Jinping Wang, Bo Zhang, and Hui Li
Subjects: medicine.medical_specialty, education.field_of_study, Glucose tolerance test, medicine.diagnostic_test, business.industry, Endocrinology, Diabetes and Metabolism, Incidence (epidemiology), Hazard ratio, Population, medicine.disease, law.invention, Impaired glucose tolerance, Endocrinology, Randomized controlled trial, law, Diabetes mellitus, Internal medicine, Internal Medicine, medicine, Physical therapy, Cumulative incidence, education, business
Abstract: Summary Background Lifestyle interventions among people with impaired glucose tolerance reduce the incidence of diabetes, but their effect on all-cause and cardiovascular disease mortality is unclear. We assessed the long-term effect of lifestyle intervention on long-term outcomes among adults with impaired glucose tolerance who participated in the Da Qing Diabetes Prevention Study. Methods The study was a cluster randomised trial in which 33 clinics in Da Qing, China—serving 577 adults with impaired glucose tolerance—were randomised (1:1:1:1) to a control group or lifestyle intervention groups (diet or exercise or both). Patients were enrolled in 1986 and the intervention phase lasted for 6 years. In 2009, we followed up participants to assess the primary outcomes of cardiovascular mortality, all-cause mortality, and incidence of diabetes in the intention-to-treat population. Findings Of the 577 patients, 439 were assigned to the intervention group and 138 were assigned to the control group (one refused baseline examination). 542 (94%) of 576 participants had complete data for mortality and 568 (99%) contributed data to the analysis. 174 participants died during the 23 years of follow-up (121 in the intervention group vs 53 in the control group). Cumulative incidence of cardiovascular disease mortality was 11·9% (95% CI 8·8–15·0) in the intervention group versus 19·6% (12·9–26·3) in the control group (hazard ratio [HR] 0·59, 95% CI 0·36–0·96; p=0·033). All-cause mortality was 28·1% (95% CI 23·9–32·4) versus 38·4% (30·3–46·5; HR 0·71, 95% CI 0·51–0·99; p=0·049). Incidence of diabetes was 72·6% (68·4–76·8) versus 89·9% (84·9–94·9; HR 0·55, 95% CI 0·40–0·76; p=0·001). Interpretation A 6-year lifestyle intervention programme for Chinese people with impaired glucose tolerance can reduce incidence of cardiovascular and all-cause mortality and diabetes. These findings emphasise the long-term clinical benefits of lifestyle intervention for patients with impaired glucose tolerance and provide further justification for adoption of lifestyle interventions as public health measures to control the consequences of diabetes. Funding Centers for Disease Control and Prevention, WHO, the China-Japan Friendship Hospital, Da Qing First Hospital.
Published: 2014
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12. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy: A World Health Organization Guideline

Author: Robert G. Moses, Yasue Omori, Ana Pilar Betrán, Spb Mendis, Ingvars Rasa, Seshiah, Stephen Colagiuri, A Mikhailov, Mario Merialdi, GL Stewart, Maria Inês Schmidt, Huixia Yang, David Simmons, Eugene Sobngwi, Michel Boulvain, AK Jenum, Moshe Hod, Mukesh M. Agarwal, Maicon Falavigna, N Samad, Sara Meltzer, Who, Guideline, Steering, Grp, Boyd E. Metzger, Torloni, T Lao, Edward J. Coetzee, Gojka Roglic, and Balaji
Subjects: medicine.medical_specialty, Pediatrics, Pregnancy, business.industry, Endocrinology, Diabetes and Metabolism, Pregnancy in Diabetics, Alternative medicine, General Medicine, Guideline, World Health Organization, medicine.disease, World health, Diabetes, Gestational, Endocrinology, Hyperglycemia, Diabetes mellitus, Internal Medicine, Humans, Medicine, Female, business, Intensive care medicine
Published: 2014
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13. The Oxford International Diabetes Summit: Implications of the DAWN study: 7-8 April 2002, Oxford, UK

Author: David R. Matthews, Richard R. Rubin, Ole Molskov Bech, and Gojka Roglic
Subjects: Gerontology, Long lasting, geography, Summit, geography.geographical_feature_category, business.industry, Endocrinology, Diabetes and Metabolism, education, Stakeholder, Key issues, Nursing, General partnership, Health care, Well-being, Internal Medicine, Medicine, sense organs, business, Psychosocial
Abstract: The DAWN (Diabetes Attitudes, Wishes and Needs) study was instigated by Novo Nordisk in order to assess the perceptions and attitudes of people with diabetes and health care providers to the management and care of diabetes. The study was conducted between August 2000 and September 2001 in 11 countries or regions: Australia, France, Germany, India, Japan, Poland, Spain, The Netherlands, United Kingdom, Scandinavia (Denmark, Norway and Sweden) and the USA, with the focus on drivers of effective self-management amongst over 5400 people with diabetes and over 3800 diabetes health care providers (specialist doctors, GPs and nurses). The objective of the DAWN study was to provide information of value in improving diabetes care and the well being of diabetic patients and to enhance and complement data derived from other reported psychosocial studies. To this end, the first Oxford DAWN International Summit met to consider its implications and resolve ways in which the findings of the DAWN study could be implemented. The interactive nature of the summit was enhanced by the use of computer-linked individual keypads, so that delegates could participate interactively and vote on a range of issues. Following presentations on the key issues surrounding DAWN, a series of participant workshops considered the issues that had been raised and produced their recommendations for future action. Opening the Summit, Chairman Dr David Matthews (Chairman of the Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford, UK) commented on its multi-national and multi-disciplinary nature and how this was bringing together different stakeholder perspectives. Use of the keypads showed that Denmark, USA, Germany and the UK (in that order) were the best represented. Delegates included diabetologists, nurses, behavioural scientists, GPs, patients and health payors. These different perspectives would be important in arriving at conclusions. The DAWN study had endeavoured to discover the person behind the patient and to establish to what degree self-care management truly involved a partnership between patient and health care provider. Dr Matthews emphasised the psychosocial nature of the survey and the ways in which this aspect of care had perhaps been somewhat neglected in the past. DAWN represented an opportunity for change; this challenge should be welcomed. He hoped that the outcome of the summit would have a long lasting effect over the coming years. Copyright © 2002 John Wiley & Sons, Ltd.
Published: 2016

14. Cardiovascular risk reduction following diagnosis of diabetes by screening: 1-year results from the ADDITION-Cambridge trial cohort

Author: Stephen J. Sharp, Nicholas J. Wareham, Morten Charles, Ann Louise Kinmonth, Gojka Roglic, Kate M. Williams, Simon J. Griffin, and Rebecca K. Simmons
Subjects: Male, medicine.medical_specialty, Waist, Hypercholesterolemia, Health Promotion, Disease, Type 2 diabetes, Body Mass Index, law.invention, Randomized controlled trial, Risk Factors, Weight loss, law, Internal medicine, Diabetes mellitus, medicine, Cluster Analysis, Humans, Hypoglycemic Agents, Single-Blind Method, Medical prescription, Life Style, Antihypertensive Agents, Aged, Hypolipidemic Agents, Glycated Hemoglobin, business.industry, Research, Smoking, Middle Aged, medicine.disease, Surgery, Early Diagnosis, Diabetes Mellitus, Type 2, Hypertension, Cohort, Female, Waist Circumference, medicine.symptom, Family Practice, business, Risk Reduction Behavior, Diabetic Angiopathies, Follow-Up Studies
Abstract: Background Uncertainties persist concerning the effects of early intensive management of type 2 diabetes and which patients benefit most from such an approach. Aim To describe change in modelled cardiovascular risk in the 14 months following diagnosis, and to examine which baseline patient characteristics and treatment components are associated with risk reduction. Design and setting A cohort of individuals from a pragmatic, single-blind, cluster-randomised controlled trial of 236 females and 361 males with screen-detected type 2 diabetes and without prior cardiovascular disease (CVD), from 49 GP surgeries in eastern England, examined at baseline (2002–2006) and after 14-months’ follow-up. Method Multiple linear regression was used to quantify the association between baseline patient characteristics, treatment components, and change in modelled 10-year cardiovascular risk (UK Prospective Diabetes Study [UKPDS] [version 3] risk engine). Results There was a downward shift in the distribution of modelled CVD risk over 14 months mean 31% (standard deviation [SD] = 14%) to 26% [SD = 13%]). Older individuals, males, and those with a larger waist circumference at baseline exhibited smaller risk reductions. Individuals prescribed higher numbers of drugs over the follow-up period, and those who decreased their energy intake or reduced their weight, demonstrated larger reductions in modelled risk. Conclusion It is possible to achieve significant reductions in modelled CVD risk over 14 months following diagnosis of diabetes by screening. Risk reduction appeared to be driven mainly by prescription of higher numbers of drugs, decreased energy intake, and weight reduction. There was room for further risk reduction, as many patients were not prescribed recommended treatments.
Published: 2012
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15. Medicines for Treatment Intensification in Type 2 Diabetes and Type of Insulin in Type 1 and Type 2 Diabetes in Low-Resource Settings: Synopsis of the World Health Organization Guidelines on Second- and Third-Line Medicines and Type of Insulin for the Control of Blood Glucose Levels in Nonpregnant Adults With Diabetes Mellitus

Author: Gojka Roglic and Susan L Norris
Subjects: medicine.medical_specialty, Type 1 diabetes, business.industry, medicine.drug_class, Insulin, medicine.medical_treatment, 030209 endocrinology & metabolism, General Medicine, Type 2 diabetes, Hypoglycemia, medicine.disease, Sulfonylurea, Metformin, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, Internal Medicine, medicine, 030212 general & internal medicine, Intensive care medicine, business, Glycemic, medicine.drug
Abstract: Description The World Health Organization developed these guidelines to provide guidance on selection of medicines for treatment intensification in type 2 diabetes and on use of insulin (human or analogue) in type 1 and 2 diabetes. The target audience includes clinicians, policymakers, national diabetes program managers, and medicine procurement officers. The target population is adults with type 1 or 2 diabetes in low-resource settings in low- or high-income countries. The guidelines also apply to disadvantaged populations in high-income countries. Methods The recommendations were formulated by a 12-member guideline development group and are based on high-quality systematic reviews identified via a search of several bibliographic databases from 1 January 2007 to 1 March 2017. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) system was used to assess the quality of the evidence and the strength of the recommendations. The guideline was peer-reviewed by 6 external reviewers. Recommendation 1 Give a sulfonylurea to patients with type 2 diabetes who do not achieve glycemic control with metformin alone or who have contraindications to metformin (strong recommendation, moderate-quality evidence). Recommendation 2 Introduce human insulin treatment to patients with type 2 diabetes who do not achieve glycemic control with metformin and/or a sulfonylurea (strong recommendation, very-low-quality evidence). Recommendation 3 If insulin is unsuitable, a dipeptidyl peptidase-4 (DPP-4) inhibitor, a sodium-glucose cotransporter-2 (SGLT-2) inhibitor, or a thiazolidinedione (TZD) may be added (weak recommendation, very-low-quality evidence). Recommendation 4 Use human insulin to manage blood glucose in adults with type 1 diabetes and in adults with type 2 diabetes for whom insulin is indicated (strong recommendation, low-quality evidence). Recommendation 5 Consider long-acting insulin analogues to manage blood glucose in adults with type 1 or type 2 diabetes who have frequent severe hypoglycemia with human insulin (weak recommendation, moderate-quality evidence for severe hypoglycemia).
Published: 2018
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16. Defining the research agenda to reduce the joint burden of disease from Diabetes mellitus and Tuberculosis

Author: Ib C. Bygbjerg, Anthony D. Harries, Susan P. Fisher-Hoch, Gojka Roglic, Toru Mori, Salah Eddine Ottmani, Vijay Viswanathan, Christie Y. Jeon, Knut Lönnroth, David Whiting, Megan Murray, Kaushik Ramaiya, Anil Kapur, Nils Billo, Nigel Unwin, Hanne Strandgaard, Mauricio Lima Barreto, and Richard Brostrom
Subjects: Burden of disease, medicine.medical_specialty, Tuberculosis, endocrine system diseases, business.industry, Public Health, Environmental and Occupational Health, MEDLINE, Health services research, nutritional and metabolic diseases, medicine.disease, Infectious Diseases, Tuberculosis diagnosis, Diabetes mellitus, Medicine, Parasitology, In patient, business, Intensive care medicine, Mass screening
Abstract: The steadily growing epidemic of diabetes mellitus poses a threat for global tuberculosis (TB) control. Previous studies have identified an important association between diabetes mellitus and TB. However, these studies have limitations: very few were carried out in low-income countries, with none in Africa, raising uncertainty about the strength of the diabetes mellitus-TB association in these settings, and many critical questions remain unanswered. An expert meeting was held in November 2009 to discuss where there was sufficient evidence to make firm recommendations about joint management of both diseases, to address research gaps and to develop a research agenda. Ten key research questions were identified, of which 4 were selected as high priority: (i) whether, when and how to screen for TB in patients with diabetes mellitus and vice versa; (ii) the impact of diabetes mellitus and non-diabetes mellitus hyperglycaemia on TB treatment outcomes and deaths, and the development of strategies to improve outcomes; (iii) implementation and evaluation of the tuberculosis 'DOTS' model for diabetes mellitus management; and (iv) the development and evaluation of better point-of-care diagnostic and monitoring tests, including measurements of blood glucose and glycated haemoglobin A(1c) (HbA(1c)) for patients with diabetes mellitus. Implementation of this research agenda will benefit the control of both diseases.
Published: 2010
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17. Relationship Between Risk Factors and Mortality in Type 1 Diabetic Patients in Europe

Author: Gojka Roglic, Daniel Witte, Francesco Giorgino, Marco Songini, Monica Nannipieri, Carlo Cagini, Jose Boavida, and Massimo Porta
Subjects: Advanced and Specialized Nursing, medicine.medical_specialty, Type 1 diabetes, business.industry, Endocrinology, Diabetes and Metabolism, Mortality rate, Hazard ratio, 030209 endocrinology & metabolism, 030204 cardiovascular system & hematology, medicine.disease, 3. Good health, Surgery, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, Internal medicine, Epidemiology, Internal Medicine, Medicine, Risk factor, business, Prospective cohort study, Cohort study
Abstract: OBJECTIVE—The purpose of this study was to examine risk factors for mortality in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS—Baseline risk factors were measured in the EURODIAB Prospective Cohort Study with 2,787 type 1 diabetic patients (51% men and 49% women) recruited from 16 European countries. Mortality data were collected during a 7-year follow-up. RESULTS—There was an annual mortality rate of 5 per 1,000 person-years in patients with type 1 diabetes (mean age at baseline 33 years, range 15–61 years); of the total 2,787 subjects, 102 died. The final multivariable model contained age at baseline (standardized hazard ratio 1.78 [95% CI 1.44–2.20]), A1C (1.18 [0.95–1.46]), waist-to-hip ratio (WHR) (1.32 [1.14–1.52]), pulse pressure (1.33 [1.13–1.58]), and non-HDL cholesterol (1.33 [1.12–1.60]) as risk factors for all-cause mortality. Macroalbuminuria (2.39 [1.19–4.78]) and peripheral (1.88 [1.06–3.35]) and autonomic neuropathy (2.40 [1.32–4.36]) were the most important risk markers for mortality. Similar risk factors were found for all-cause, non-cardiovascular disease (CVD), unknown-cause, and CVD mortality. CONCLUSIONS—Important risk factors for the increased total and non-CVD mortality in type 1 diabetic patients are age, WHR, pulse pressure, and non-HDL cholesterol. Microvascular complications from macroalbuminuria and peripheral and autonomic neuropathy are strong risk markers for future mortality exceeding the effect of the traditional risk factors.
Published: 2008
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18. Diabetes and the risk of tuberculosis: a neglected threat to public health?

Author: Brian G. Williams, Julia A Critchley, Nigel Unwin, Christopher Dye, Gojka Roglic, Catherine R. Stevenson, and Nita G. Forouhi
Subjects: Adult, Male, medicine.medical_specialty, Tuberculosis, 030231 tropical medicine, MEDLINE, Risk Assessment, Odds, 03 medical and health sciences, 0302 clinical medicine, Environmental health, Diabetes Mellitus, Humans, Medicine, 030212 general & internal medicine, Aged, Aged, 80 and over, business.industry, Health Policy, Public health, Confounding, General Medicine, Middle Aged, medicine.disease, Surgery, Sample size determination, Cohort, Female, Public Health, business, Risk assessment
Abstract: Objectives: Tuberculosis (TB) remains a major global public health problem. In the past, a relationship between TB and diabetes mellitus (DM) was recognized, and its importance was acknowledged through joint treatment clinics. However, this is rarely highlighted in current research or control priorities. This paper aims to evaluate the evidence for an association between these two diseases.Methods: A Medline literature search was undertaken, supplemented by checking references and contacting experts. We critically appraised studies that quantified the association between TB and DM, and were published after 1995. We assessed study quality according to criteria such as sample size, method of selection of cases and controls, losses to follow-up, quality and method of control of confounding, and summarized the results narratively and in tabular form.Results: All studies identified statistically significant and clinically important associations, with the increase in risk or odds of TB varying between 1.5- and 7.8-fold for those with DM. Risk was highest at younger ages. Most studies had not measured and controlled adequately for potential major confounders.Discussion: There is strong evidence for an association between TB and DM, which has potential public health implications. Further well-designed studies are needed to assess the magnitude precisely.
Published: 2007
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19. Contrasting cardiovascular mortality trends in Eastern Mediterranean populations: Contributions from risk factor changes and treatments

Author: Julia Critchley, Simon Capewell, Martin O'Flaherty, Niveen Abu-Rmeileh, Samer Rastam, Olfa Saidi, Kaan Sözmen, Azza Shoaibi, Abdullatif Husseini, Fouad Fouad, Nadia Ben Mansour, Wafa Aissi, Habiba Ben Romdhane, Belgin Unal, Piotr Bandosz, Kathleen Bennett, Mukesh Dherani, Radwan Al Ali, Wasim Maziak, Hale Arık, Gül Gerçeklioğlu, Deniz Utku Altun, Hatice Şimşek, Sinem Doganay, Yücel Demiral, Özgür Aslan, Nigel Unwin, Peter Phillimore, Nourredine Achour, Waffa Aissi, Riadh Allani, Chokra Arfa, Heidar Abu-Kteish, Deniz Altun, Balsam Ahmad, Latifa Beltaifa, Nabil Ben Salah, Marissa Collins, Madonna Elias, Gül Ergör, Ibtihal Fadhil, Rula Ghandour, Sibel Göğen, Samer Jaber, Sibel Kalaca, Rana Khatib, Rasha Khatib, Saer Koudsie, Bülent Kilic, Olfa Lassoued, Helen Mason, Maher Abou Mayaleh, Nahed Mikki, Ghmaez Moukeh, Martin O. Flaherty, Gojka Roglic, Gül Saatli, Ilhan Satman, Nesrien Soulaiman, Faten Tlili, Nazan Yardim, and Shahaduz Zaman
Subjects: Gerontology, Adult, Male, medicine.medical_specialty, Cardiovascular mortality, Tunisia, Turkey, Eastern Mediterranean, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Diabetes mellitus, Epidemiology, medicine, Trend, Humans, 030212 general & internal medicine, Risk factor, Mortality, Aged, Syria, business.industry, Mediterranean Region, Mortality rate, Smoking, Middle Aged, medicine.disease, Obesity, 3. Good health, Treatment, Blood pressure, Treatment Outcome, Cardiovascular Diseases, Population Surveillance, Hypertension, Female, Cardiology and Cardiovascular Medicine, business, Risk assessment, Body mass index, Demography, Model
Abstract: Background Middle income countries are facing an epidemic of non-communicable diseases, especially coronary heart disease (CHD). We used a validated CHD mortality model (IMPACT) to explain recent trends in Tunisia, Syria, the occupied Palestinian territory (oPt) and Turkey. Methods Data on populations, mortality, patient numbers, treatments and risk factor trends from national and local surveys in each country were collated over two time points (1995-97; 2006-09); integrated and analysed using the IMPACT model. Results Risk factor trends: Smoking prevalence was high in men, persisting in Syria but decreasing in Tunisia, oPt and Turkey. BMI rose by 1-2 kg/m2 and diabetes prevalence increased by 40%-50%. Mean systolic blood pressure and cholesterol levels increased in Tunisia and Syria. Mortality trends: Age-standardised CHD mortality rates rose by 20% in Tunisia and 62% in Syria. Much of this increase (79% and 72% respectively) was attributed to adverse trends in major risk factors, occurring despite some improvements in treatment uptake. CHD mortality rates fell by 17% in oPt and by 25% in Turkey, with risk factor changes accounting for around 46% and 30% of this reduction respectively. Increased uptake of community treatments (drug treatments for chronic angina, heart failure, hypertension and secondary prevention after a cardiac event) accounted for most of the remainder. Discussion CHD death rates are rising in Tunisia and Syria, whilst oPt and Turkey demonstrate clear falls, reflecting improvements in major risk factors with contributions from medical treatments. However, smoking prevalence remains very high in men; obesity and diabetes levels are rising dramatically. The MedCHAMPS project and data collection were funded by EC FP7 grant no. 223705 . JC and SC are supported by the UK Higher Education Funding Council . MOF was partly funded by the European Union and the UK Medical Research Council ( NPR3, Project 45 ). This study was funded by the European Community's Seventh Framework Programme (FP7/2007-2013) under grant agreement no. 223075 - the MedCHAMPS project. MOF was also supported by the UK MRC . Scopus
Published: 2015

20. World Diabetes Congress 2015: The Global Health Challenges Stream: Assessing global progress and results

Author: Gojka, Roglic
Published: 2015

21. The Burden of Mortality Attributable to Diabetes

Author: Colin Mathers, Peter H. Bennett, Nigel Unwin, Hilary King, Gojka Roglic, Satyajit Nag, Jaakko Tuomilehto, and Vincent Connolly
Subjects: Advanced and Specialized Nursing, Gerontology, education.field_of_study, medicine.medical_specialty, business.industry, Endocrinology, Diabetes and Metabolism, Incidence (epidemiology), Population, Attributable risk percent, mortality, diabetes, epidemiology, medicine.disease, Diabetes mellitus, Relative risk, Epidemiology, Internal Medicine, medicine, education, business, Disease burden, Demography, Cause of death
Abstract: OBJECTIVE—To estimate the global number of excess deaths due to diabetes in the year 2000. RESEARCH DESIGN AND METHODS—We used a computerized generic formal disease model (DisMod II), used by the World Health Organization to assess disease burden through modeling the relationships between incidence, prevalence, and disease-specific mortality. Baseline input data included population structure, age- and sex-specific estimates of diabetes prevalence, and available published estimates of relative risk of death for people with diabetes compared with people without diabetes. The results were validated with population-based observations and independent estimates of relative risk of death. RESULTS—The excess global mortality attributable to diabetes in the year 2000 was estimated to be 2.9 million deaths, equivalent to 5.2% of all deaths. Excess mortality attributable to diabetes accounted for 2–3% of deaths in poorest countries and over 8% in the U.S., Canada, and the Middle East. In people 35–64 years old, 6–27% of deaths were attributable to diabetes. CONCLUSIONS—These are the first global estimates of mortality attributable to diabetes. Globally, diabetes is likely to be the fifth leading cause of death.
Published: 2005
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22. Investigation of 2 models to set and evaluate quality targets for hb a1c: biological variation and sigma-metrics

Author: Randie R. Little, Izumi Takei, Philippe Gillery, David B. Sacks, Gojka Roglic, Garry John, Erna Lenters-Westra, Emma English, Linong Ji, and Cas Weykamp
Subjects: Glycated Hemoglobin, Standardization, Computer science, business.industry, Task force, media_common.quotation_subject, Biochemistry (medical), Clinical Biochemistry, Sigma Metrics, Models, Biological, Reliability engineering, Set (abstract data type), Biological variation, Proficiency testing, Humans, Quality (business), business, Laboratories, Quality assurance, media_common
Abstract: BACKGROUND A major objective of the IFCC Task Force on Implementation of HbA1c Standardization is to develop a model to define quality targets for glycated hemoglobin (Hb A1c). METHODS Two generic models, biological variation and sigma-metrics, are investigated. We selected variables in the models for Hb A1c and used data of external quality assurance/proficiency testing programs to evaluate the suitability of the models to set and evaluate quality targets within and between laboratories. RESULTS In the biological variation model, 48% of individual laboratories and none of the 26 instrument groups met the minimum performance criterion. In the sigma-metrics model, with a total allowable error (TAE) set at 5 mmol/mol (0.46% NGSP), 77% of the individual laboratories and 12 of 26 instrument groups met the 2σ criterion. CONCLUSIONS The biological variation and sigma-metrics models were demonstrated to be suitable for setting and evaluating quality targets within and between laboratories. The sigma-metrics model is more flexible, as both the TAE and the risk of failure can be adjusted to the situation—for example, requirements related to diagnosis/monitoring or international authorities. With the aim of reaching (inter)national consensus on advice regarding quality targets for Hb A1c, the Task Force suggests the sigma-metrics model as the model of choice, with default values of 5 mmol/mol (0.46%) for TAE and risk levels of 2σ and 4σ for routine laboratories and laboratories performing clinical trials, respectively. These goals should serve as a starting point for discussion with international stakeholders in the field of diabetes.
Published: 2014

23. Gestational diabetes mellitus: squaring the circle

Author: Gojka Roglic and Stephen Colagiuri
Subjects: Blood Glucose, medicine.medical_specialty, Pediatrics, endocrine system diseases, Endocrinology, Diabetes and Metabolism, MEDLINE, World health, Impaired glucose tolerance, Pregnancy, Diabetes mellitus, Internal Medicine, medicine, Humans, Advanced and Specialized Nursing, Glucose tolerance test, medicine.diagnostic_test, business.industry, nutritional and metabolic diseases, Glucose Tolerance Test, medicine.disease, Surgery, Gestational diabetes, Diabetes, Gestational, Who criteria, Female, business
Abstract: The World Health Organization (WHO) has recently released a new classification and diagnostic criteria for hyperglycemia first diagnosed in pregnancy (1). These new criteria are an update of the 1999 WHO criteria, which defined gestational diabetes mellitus (GDM) as diabetes or impaired glucose tolerance with onset or first recognition in pregnancy. This definition was not based on a review of the evidence, but took into account the already recognized negative effect of uncontrolled diabetes on pregnancy outcome and a suspicion that milder hyperglycemia in pregnancy could also have a negative effect on maternal and child outcomes (2). The ad hoc expert group convened for the update accepted the reasoning of the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) (3) and decided to endorse the separation of diabetes and GDM. The WHO has accepted the same glucose diagnostic thresholds for GDM as proposed by IADPSG. Globally, there is general agreement over how to diagnose diabetes in nonpregnant individuals, based on the relationship between glycemia and microvascular complications specific for diabetes. Such is …
Published: 2014

24. Diabetes in South-East Asia: burden, gaps, challenges and ways forward

Author: Thaksaphon Thamarangsi, Cherian Varghese, and Gojka Roglic
Subjects: Adult, business.industry, 030209 endocrinology & metabolism, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, Diabetes Mellitus, Prevalence, medicine, Humans, 030212 general & internal medicine, South east asia, Child, business, Socioeconomics, Delivery of Health Care, Asia, Southeastern
Published: 2016
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25. Impact of gestational diabetes mellitus screening strategies on perinatal outcomes: a simulation study

Author: Maicon Falavigna, Stephen Colagiuri, Maria Inês Schmidt, Gojka Roglic, Isaías Valente Prestes, and Bruce Bartholow Duncan
Subjects: Adult, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Models, Biological, Preeclampsia, Fetal Macrosomia, Endocrinology, Pre-Eclampsia, Pregnancy, Diabetes mellitus, Internal Medicine, Medicine, Humans, Mass Screening, Computer Simulation, business.industry, Obstetrics, Cesarean Section, Incidence (epidemiology), Incidence, Infant, Newborn, Pregnancy Outcome, Gestational age, General Medicine, Evidence-based medicine, medicine.disease, Gestational diabetes, Diabetes, Gestational, Systematic review, Cohort, Female, business, Monte Carlo Method
Abstract: Aims To evaluate the impact on perinatal outcomes of universal gestational diabetes (GDM) screening based on 1999 WHO and IADPSG diagnostic criteria; to assess the quality of the evidence (GRADE) to support GDM screening. Methods Simulation of a hypothetical cohort of community-based pregnant women with 10% GDM prevalence (1999 WHO). Most parameters were obtained from recent systematic reviews. Results Compared to no screening, screening based on 1999 WHO criteria (followed by treatment) reduced the incidence of large for gestational age (LGA) neonates by 0.53% (95% CI 0.37–0.74%; NNS = 189) and of preeclampsia by 0.27% (0.10–0.45%; NNS = 376). Screening based on IADPSG criteria reduced incidences by 0.85% (0.54–1.29%; NNS = 117) and by 0.39% (0.15–0.65%; NNS = 257), respectively. Compared to screening based on 1999 WHO criteria, screening with IADPSG criteria reduced the incidence of LGA by 0.32% (0.09–0.63%; NNS = 309) and of preeclampsia by 0.12% (0.01–0.25; NNS = 808). The quality of evidence for both screening approaches is very low. Conclusions Universal screening for GDM has only a modest impact on pregnancy outcomes. The impact of screening based on IADPSG (vs. WHO, 1999) criteria is slightly larger. However, costs and resources should also be considered in local selection of a screening approach.
Published: 2012

26. Serum high-mobility group box-1 levels are positively associated with micro- and macroalbuminuria but not with cardiovascular disease in type 1 diabetes: the EURODIAB Prospective Complications Study

Author: Gojka Roglic, Coen Stehouwer, Maria Isabel Ferreira de Sousa, Francesco Giorgino, Marco Songini, Monica Nannipieri, Casper G Schalkwijk, Anna Casu, Carlo Cagini, Steve Aldington, Jose Boavida, MUMC+: MA Med Staf Artsass Interne Geneeskunde (9), Interne Geneeskunde, Epidemiologie, MUMC+: KIO Kemta (9), MUMC+: MA Interne Geneeskunde (3), and RS: CARIM School for Cardiovascular Diseases
Subjects: Adult, Male, medicine.medical_specialty, type 1 diabetes, Endocrinology, Diabetes and Metabolism, micro and macroalbuminuria, Severity of Illness Index, Nephropathy, Diabetes Complications, cardiovascular disease, Endocrinology, Risk Factors, Internal medicine, Diabetes mellitus, Diabetes Mellitus, medicine, Albuminuria, Humans, HMGB1 Protein, Type 1 diabetes, business.industry, Case-control study, Settore MED/13 - ENDOCRINOLOGIA, General Medicine, Odds ratio, Middle Aged, medicine.disease, Europe, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Cardiovascular Diseases, Case-Control Studies, Arterial stiffness, Biological Markers, Female, medicine.symptom, business, Biomarkers, Type 1, Glomerular Filtration Rate, Retinopathy
Abstract: Context and objectiveHigh-mobility group box-1 (HMGB1) is a pro-inflammatory cytokine that may contribute to the pathogenesis of micro- and macrovascular complications commonly observed in diabetes. We investigated whether HMGB1 is associated with: i) markers of low-grade inflammation (LGI) and endothelial dysfunction (ED) and pulse pressure (PP, a marker of arterial stiffness); ii) prevalent nephropathy, retinopathy and cardiovascular disease (CVD) in type 1 diabetes; and iii) the potential mediating roles of LGI, ED and PP therein.Design and methodsThis was a cross-sectional nested case–control study of 463 patients (226 women; mean age 40±10 years) with type 1 diabetes from the EURODIAB Prospective Complications Study. We used linear and binary or multinomial logistic regression analyses adjusted for traditional risk factors.ResultsSerum Ln-HMGB1 levels were positively associated with LGI and ED (standardisedβ=0.07 (95% confidence interval (CI): 0.02–0.12) andβ=0.08 (95% CI: 0.02–0.14) respectively), but not with PP. Higher Ln-HMGB1 (per unit) was associated with greater odds of micro- and macroalbuminuria: odds ratio (OR)=1.24 (95% CI: 0.90–1.71) and OR=1.61 (95% CI: 1.15–2.25) respectively,Pfor trend=0.004. Further adjustments for LGI or ED did not attenuate these associations. No such associations were found between Ln-HMGB1 and estimated glomerular filtration rate (eGFR), retinopathy or CVD, however.ConclusionsIn type 1 diabetes, higher serum HMGB1 levels are associated with greater prevalence and severity of albuminuria, though not with eGFR, retinopathy and CVD. Prospective studies are needed to clarify the causal role of HMGB1, if any, in the pathogenesis of vascular complications in type 1 diabetes.
Published: 2012

27. Dietary saturated fat and fibre and risk of cardiovascular disease and all-cause mortality among type 1 diabetic patients: the EURODIAB Prospective Complications Study

Author: Gojka Roglic, Francesco Giorgino, Marco Songini, Monica Nannipieri, Anna Casu, Carlo Cagini, Steve Aldington, Jose Boavida, and Danielle Schoenaker
Subjects: Dietary Fiber, Male, Nutrition and Disease, type 1 diabetes, Saturated fat, Endocrinology, Diabetes and Metabolism, 030204 cardiovascular system & hematology, Replacement of saturated fat, chemistry.chemical_compound, 0302 clinical medicine, prevention, Risk Factors, Voeding en Ziekte, Prevalence, Prospective Studies, Prospective cohort study, Dietary fibre, food and beverages, cohort, Middle Aged, All-cause mortality, Cardiovascular disease, Diet Records, 3. Good health, Europe, Cardiovascular Diseases, dietary fat, Saturated fatty acid, Hypertension, Female, women, pooled analysis, associations, Type 1, Adult, medicine.medical_specialty, Adolescent, cereal fiber, Hypercholesterolemia, 030209 endocrinology & metabolism, risk of cardioascular disease, Diabetic angiopathy, Saturated fat type 1 diabetes, Article, insulin-resistance, 03 medical and health sciences, Young Adult, Insulin resistance, Patient Education as Topic, Internal medicine, Diabetes mellitus, medicine, Internal Medicine, Diabetes Mellitus, Humans, iddm complications, VLAG, Nutrition, Type 1 diabetes, business.industry, Cholesterol, cholesterol, Settore MED/13 - ENDOCRINOLOGIA, medicine.disease, Dietary Fats, Endocrinology, Diabetes Mellitus, Type 1, chemistry, Patient Compliance, business, coronary-heart-disease, Energy Intake, Diabetic Angiopathies, Follow-Up Studies
Abstract: Aims/hypothesis Low adherence to recommendations for dietary saturated fatty acid (SFA) and fibre intake in patients with type 1 diabetes mellitus may heighten their increased risk of cardiovascular disease (CVD) and mortality. We examined the relationship of SFA and total, soluble and insoluble fibre with incident CVD and all-cause mortality in type 1 diabetic patients. Methods A prospective cohort analysis was performed in 2,108 European type 1 diabetic patients aged 15–60 years who were free of CVD at baseline and enrolled in the EURODIAB Prospective Complications Study (51% male). Diet was assessed from a standardised 3 day dietary record. HR were calculated using Cox proportional hazards models. Results During a mean follow-up of 7.3 years, 148 incident cases of fatal and non-fatal CVD and 46 all-cause deaths were documented. No statistically significant association was found between SFA and CVD and all-cause mortality. Total dietary fibre, per 5 g/day, was associated with lower all-cause mortality risk (HR 0.72; 95% CI 0.55, 0.95). This association was stronger for soluble fibre (per 5 g/day, HR 0.34; 95% CI 0.14, 0.80) compared with insoluble fibre (per 5 g/day; HR 0.66; 95% CI 0.45, 0.97). Similar results were found for the association with CVD. Conclusions/interpretation This study suggests that reported dietary SFA is not significantly associated with CVD and all-cause mortality in type 1 diabetic patients. On the contrary, higher dietary fibre consumption, especially soluble fibre, within the range commonly consumed by type 1 diabetic patients, may contribute to the prevention of CVD and all-cause mortality in type 1 diabetic patients. Electronic supplementary material The online version of this article (doi:10.1007/s00125-012-2550-0) contains peer-reviewed but unedited supplementary material, which is available to authorised users.
Published: 2011

28. Nutrition, diabetes and tuberculosis in the epidemiological transition

Author: Gojka Roglic, Knut Lönnroth, Brian G. Williams, Bernadette Bourdin Trunz, and Christopher Dye
Subjects: Adult, Male, Gerontology, Tuberculosis, Epidemiology, Science Policy, India, Nutritional Status, lcsh:Medicine, Global Health, Body Mass Index, Science Policy and Economics, Risk Factors, Diabetes mellitus, Environmental health, Diabetes Mellitus, medicine, Humans, lcsh:Science, Biology, Nutrition, Korea, Multidisciplinary, Population Biology, business.industry, Tb control, lcsh:R, Diabetes prevalence, Nutritional status, medicine.disease, Epidemiological transition, Infectious Diseases, Metabolic Disorders, Medicine, Female, lcsh:Q, Public Health, business, Body mass index, Research Article
Abstract: BACKGROUND: Diabetes prevalence and body mass index reflect the nutritional profile of populations but have opposing effects on tuberculosis risk. Interactions between diabetes and BMI could help or hinder TB control in growing, aging, urbanizing populations. METHODS AND FINDINGS: We compiled data describing temporal changes in BMI, diabetes prevalence and population age structure in rural and urban areas for men and women in countries with high (India) and low (Rep. Korea) TB burdens. Using published data on the risks of TB associated with these factors, we calculated expected changes in TB incidence between 1998 and 2008. In India, TB incidence cases would have increased (28% from 1.7 m to 2.1 m) faster than population size (22%) because of adverse effects of aging, urbanization, changing BMI and rising diabetes prevalence, generating an increase in TB incidence per capita of 5.5% in 10 years. In India, general nutritional improvements were offset by a fall in BMI among the majority of men who live in rural areas. The growing prevalence of diabetes in India increased the annual number of TB cases in people with diabetes by 46% between 1998 and 2008. In Korea, by contrast, the number of TB cases increased more slowly (6.1% from 40,200 to 42,800) than population size (14%) because of positive effects of urbanization, increasing BMI and falling diabetes prevalence. Consequently, TB incidence per capita fell by 7.8% in 10 years. Rapid population aging was the most significant adverse effect in Korea. CONCLUSIONS: Nutritional and demographic changes had stronger adverse effects on TB in high-incidence India than in lower-incidence Korea. The unfavourable effects in both countries can be overcome by early drug treatment but, if left unchecked, could lead to an accelerating rise in TB incidence. The prevention and management of risk factors for TB would reinforce TB control by chemotherapy.
Published: 2011

29. Long-term effects of a randomised trial of a 6-year lifestyle intervention in impaired glucose tolerance on diabetes-related microvascular complications: the China Da Qing Diabetes Prevention Outcome Study

Author: Jinping Wang, J. Zhang, Peter H. Bennett, Ying Shuai, Q. Gong, Gojka Roglic, Bo Zhang, Robert B. Gerzoff, Wenying Yang, Hongliang Li, Y. Jiang, Y. Hu, Yali An, Guangwei Li, Edward W. Gregg, and Ping Zhang
Subjects: Lifestyle intervention, Male, Endocrinology, Diabetes and Metabolism, law.invention, Impaired glucose tolerance, MELLITUS, Randomized controlled trial, Diabetic Neuropathies, law, Diabetic retinopathy, PROGRAM, Diabetic Nephropathies, VASCULAR-DISEASE, Middle Aged, PREVALENCE, Female, Life Sciences & Biomedicine, Retinopathy, Adult, medicine.medical_specialty, RETINOPATHY, Nephropathy, 1117 Public Health and Health Services, Diabetes Complications, Endocrinology & Metabolism, AGE, Internal medicine, Diabetes mellitus, Glucose Intolerance, Internal Medicine, medicine, Diabetes Mellitus, Humans, Life Style, PIMA-INDIANS, Science & Technology, business.industry, MORTALITY, Microangiopathy, IGT, 1103 Clinical Sciences, medicine.disease, Surgery, Neuropathy, 1114 Paediatrics and Reproductive Medicine, business, FOLLOW-UP, Kidney disease
Abstract: Aims/hypothesis We determined the effects of 6 years of lifestyle intervention in persons with impaired glucose tolerance (IGT) on the development of retinopathy, nephropathy and neuropathy over a 20 year period. Methods In 1986, 577 adults with IGT from 33 clinics in Da Qing, China were randomly assigned by clinic to a control group or one of three lifestyle intervention groups (diet, exercise, and diet plus exercise). Active intervention was carried out from 1986 to 1992. In 2006 we conducted a 20 year follow-up study of the original participants to compare the incidence of microvascular complications in the combined intervention group vs the control group. Results Follow-up information was obtained on 542 (94%) of the 577 original participants. The cumulative incidence of severe retinopathy was 9.2% in the combined intervention group and 16.2% in the control group (p = 0.03, log-rank test). After adjusting for clinic and age, the incidence of severe retinopathy was 47% lower in the intervention group than the control group (hazard rate ratio 0.53, 95% CI 0.29–0.99, p = 0.048). No significant differences were found in the incidence of severe nephropathy (hazard rate ratio 1.05, 95% CI 0.16–7.05, intervention vs control, p = 0.96) or in the prevalence of neuropathy (8.6% vs 9.1%, p = 0.89) among the 20 year survivors. Conclusions/interpretation Lifestyle intervention for 6 years in IGT was associated with a 47% reduction in the incidence of severe, vision-threatening retinopathy over a 20 year interval, primarily due to the reduced incidence of diabetes in the intervention group. However, similar benefits were not seen for nephropathy or neuropathy.
Published: 2010

30. Social determinants of diabetes and challenges of prevention

Author: Nigel Unwin, David Whiting, and Gojka Roglic
Subjects: Gerontology, Adult, Male, Poverty, business.industry, MEDLINE, Developing country, General Medicine, Middle Aged, medicine.disease, Young Adult, Diabetes Mellitus, Type 2, Socioeconomic Factors, Diabetes mellitus, Medicine, Humans, Female, Social determinants of health, Young adult, business, Developing Countries
Published: 2010

31. Mortality attributable to diabetes: estimates for the year 2010

Author: Nigel Unwin and Gojka Roglic
Subjects: Gerontology, Adult, Male, Risk, medicine.medical_specialty, Asia, Endocrinology, Diabetes and Metabolism, Prevalence, Disease, Global Health, Middle East, Young Adult, Endocrinology, Diabetes mellitus, Epidemiology, Internal Medicine, Global health, medicine, Diabetes Mellitus, Humans, Young adult, Aged, Sex Characteristics, business.industry, Age Factors, General Medicine, Middle Aged, medicine.disease, Europe, Relative risk, Africa, Female, Americas, business, Sex characteristics, Demography
Abstract: Country and global health statistics underestimate the number of excess deaths due to diabetes. The aim of the study was to provide a more accurate estimate of the number of deaths attributable to diabetes for the year 2010. A computerized disease model was used to obtain the estimates. The baseline input data included the population structure, estimates of diabetes prevalence, estimates of underlying mortality and estimates of the relative risk of death for people with diabetes compared to people without diabetes. The total number of excess deaths attributable to diabetes worldwide was estimated to be 3.96 million in the age group 20-79 years, 6.8% of global (all ages) mortality. Diabetes accounted for 6% of deaths in adults in the African Region, to 15.7% in the North American Region. Beyond 49 years of age diabetes constituted a higher proportion of deaths in females than in males in all regions, reaching over 25% in some regions and age groups. Thus, diabetes is a considerable cause of premature mortality, a situation that is likely to worsen, particularly in low and middle income countries as diabetes prevalence increases. Investments in primary and secondary prevention are urgently required to reduce this burden.
Published: 2009

32. The metabolic syndrome: useful concept or clinical tool? Report of a WHO Expert Consultation

Author: Qing Qiao, B. Hama Sambo, Gojka Roglic, I. Brajkovich Mirchov, K. G. Alberti, Gerald M. Reaven, Naoko Tajima, Stephen Colagiuri, Edwin A M Gale, Rebecca K. Simmons, Jaakko Tuomilehto, Ambady Ramachandran, Shanthi Mendis, and A. Ben-nakhi
Subjects: medicine.medical_specialty, Diabetes risk, Physiology, Endocrinology, Diabetes and Metabolism, Population, MEDLINE, 030209 endocrinology & metabolism, QD415-436, Disease, 030204 cardiovascular system & hematology, World Health Organization, Biochemistry, 03 medical and health sciences, Endocrinology, 0302 clinical medicine, Patient Education as Topic, Risk Factors, Internal medicine, Diabetes mellitus, Epidemiology, Internal Medicine, Diabetes Mellitus, QP1-981, Medicine, 030212 general & internal medicine, Obesity, Psychiatry, Intensive care medicine, education, Metabolic Syndrome, education.field_of_study, Nutrition and Dietetics, business.industry, Public health, Public Health, Environmental and Occupational Health, Expert consultation, medicine.disease, 3. Good health, Cardiovascular Diseases, Public Health, Metabolic syndrome, business
Abstract: This article presents the conclusions of a WHO Expert Consultation that evaluated the utility of the ‘metabolic syndrome’ concept in relation to four key areas: pathophysiology, epidemiology, clinical work and public health. The metabolic syndrome is a concept that focuses attention on complex multifactorial health problems. While it may be considered useful as an educational concept, it has limited practical utility as a diagnostic or management tool. Further efforts to redefine it are inappropriate in the light of current knowledge and understanding, and there is limited utility in epidemiological studies in which different definitions of the metabolic syndrome are compared. Metabolic syndrome is a pre-morbid condition rather than a clinical diagnosis, and should thus exclude individuals with established diabetes or known cardiovascular disease (CVD). Future research should focus on: (1) further elucidation of common metabolic pathways underlying the development of diabetes and CVD, including those clustering within the metabolic syndrome; (2) early-life determinants of metabolic risk; (3) developing and evaluating context-specific strategies for identifying and reducing CVD and diabetes risk, based on available resources; and (4) developing and evaluating population-based prevention strategies.
Published: 2009

33. Diabetes in women: the global perspective

Author: Gojka Roglic
Subjects: Gerontology, Male, medicine.medical_specialty, Population ageing, Prevalence, Type 2 diabetes, Global Health, Diabetes Complications, 03 medical and health sciences, 0302 clinical medicine, Sex Factors, Pregnancy, Risk Factors, Diabetes mellitus, Epidemiology, Global health, Medicine, Humans, 030212 general & internal medicine, Obesity, Developing Countries, Life Style, 030219 obstetrics & reproductive medicine, business.industry, Age Factors, Obstetrics and Gynecology, General Medicine, medicine.disease, Diabetes, Gestational, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, business, Demography
Abstract: The prevalence of diabetes, and type 2 diabetes in particular, in women is increasing worldwide, although it is more pronounced in low-income countries. This increase is mostly due to population ageing and the ubiquitous rise in prevalence of obesity. Some of this rise is potentially preventable through lifestyle changes. A higher proportion of deaths in women than in men is attributable to diabetes. This article provides an overview of the specificities of diabetes in women and the implications of diabetes onset shifting to women of reproductive age.
Published: 2009

34. Bimodal distribution of glucose is not universally useful for diagnosing diabetes

Author: Torben Jørgensen, Peter Bjerregaard, Gojka Roglic, Michael Marmot, Pedro De Pablos Velasco, Rachel Dankner, Dorte Vistisen, Stephen Colagiuri, Epidemiology and Data Science, General practice, and EMGO - Lifestyle, overweight and diabetes
Subjects: Adult, Blood Glucose, Male, Research design, medicine.medical_specialty, Adolescent, complications, Endocrinology, Diabetes and Metabolism, Population, prevalence, Physiology, Blood sugar, Type 2 diabetes, 2-hour glucose, Impaired glucose tolerance, Young Adult, ukpds, Diabetes mellitus, Internal medicine, Diabetes Mellitus, Internal Medicine, medicine, Humans, Distribution (pharmacology), Epidemiology/Health Services Research, Child, education, Aged, VLAG, Aged, 80 and over, Advanced and Specialized Nursing, tolerance distributions, education.field_of_study, criteria, business.industry, Data Collection, Fasting, Middle Aged, medicine.disease, Endocrinology, indians, Female, business, Cut-point
Abstract: OBJECTIVE—Bimodality in the distribution of glucose has been used to define the cut point for the diagnosis of diabetes. Previous studies on bimodality have primarily been in populations with a high prevalence of type 2 diabetes, including one study in a white Caucasian population. All studies included participants with known diabetes. The aim of this study was to assess whether a bimodal structure is a general phenomenon in fasting plasma glucose (FPG) and 2-h plasma glucose that is useful for deriving a common cut point for diabetes in populations of different origin, both including and excluding known diabetes. RESEARCH DESIGN AND METHODS—The Evaluation of Screening and Early Detection Strategies for Type 2 Diabetes and Impaired Glucose Tolerance (DETECT-2) project is an international collaboration pooling surveys from all continents. These studies include surveys in which plasma glucose was measured during an oral glucose tolerance test; in total, 43 studies (135,383 participants) from 27 countries were included. A mixture of two normal distributions was fitted to plasma glucose levels, and a cut point for normal glycemia was estimated as their intersection. In populations with a biologically meaningful cut point, bimodality was tested for significance. RESULTS—Distributions of FPG and 2-h plasma glucose did not, in general, produce bimodal structures useful for deriving cut points for diabetes. When present, the cut points produced were inconsistent over geographical regions. CONCLUSIONS—Deriving cut points for normal glycemia from distributions of FPG and 2-h plasma glucose does not appear to be suitable for defining diagnostic cut points for diabetes.
Published: 2009
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35. The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a 20-year follow-up study

Author: Bo Zhang, Jinping Wang, Theodore J. Thompson, Peter H. Bennett, Robert B. Gerzoff, Edward W. Gregg, Wenying Yang, Hui Li, Gojka Roglic, Hongliang Li, Yali An, Guangwei Li, Yayun Jiang, Ying Shuai, Qiuhong Gong, Ping Zhang, Yinghua Hu, and Jing-ling Zhang
Subjects: Gerontology, Adult, Male, medicine.medical_specialty, China, Time Factors, Psychological intervention, Type 2 diabetes, Impaired glucose tolerance, Internal medicine, Intervention (counseling), Diabetes mellitus, medicine, Humans, Cumulative incidence, Life Style, Aged, Randomized Controlled Trials as Topic, business.industry, Incidence (epidemiology), Incidence, Hazard ratio, General Medicine, Middle Aged, medicine.disease, Diabetes Mellitus, Type 2, Cardiovascular Diseases, Female, business, Follow-Up Studies
Abstract: Summary Background Intensive lifestyle interventions can reduce the incidence of type 2 diabetes in people with impaired glucose tolerance, but how long these benefits extend beyond the period of active intervention, and whether such interventions reduce the risk of cardiovascular disease (CVD) and mortality, is unclear. We aimed to assess whether intensive lifestyle interventions have a long-term effect on the risk of diabetes, diabetes-related macrovascular and microvascular complications, and mortality. Methods In 1986, 577 adults with impaired glucose tolerance from 33 clinics in China were randomly assigned to either the control group or to one of three lifestyle intervention groups (diet, exercise, or diet plus exercise). Active intervention took place over 6 years until 1992. In 2006, study participants were followed-up to assess the long-term effect of the interventions. The primary outcomes were diabetes incidence, CVD incidence and mortality, and all-cause mortality. Findings Compared with control participants, those in the combined lifestyle intervention groups had a 51% lower incidence of diabetes (hazard rate ratio [HRR] 0·49; 95% CI 0·33–0·73) during the active intervention period and a 43% lower incidence (0·57; 0·41–0·81) over the 20 year period, controlled for age and clustering by clinic. The average annual incidence of diabetes was 7% for intervention participants versus 11% in control participants, with 20-year cumulative incidence of 80% in the intervention groups and 93% in the control group. Participants in the intervention group spent an average of 3·6 fewer years with diabetes than those in the control group. There was no significant difference between the intervention and control groups in the rate of first CVD events (HRR 0·98; 95% CI 0·71–1·37), CVD mortality (0·83; 0·48–1·40), and all-cause mortality (0·96; 0·65–1·41), but our study had limited statistical power to detect differences for these outcomes. Interpretation Group-based lifestyle interventions over 6 years can prevent or delay diabetes for up to 14 years after the active intervention. However, whether lifestyle intervention also leads to reduced CVD and mortality remains unclear. Funding Centers for Disease Control and Prevention, WHO, the China-Japan Friendship Hospital, and Da Qing First Hospital.
Published: 2008

36. Diabetes and tuberculosis : the impact of the diabetes epidemic on tuberculosis incidence

Author: Jeremy A. Lauer, Nita G. Forouhi, Nigel Unwin, Brian G. Williams, Chirstopher Dye, Catherine R. Stevenson, Gojka Roglic, Forouhi, Nita [0000-0002-5041-248X], and Apollo - University of Cambridge Repository
Subjects: Adult, Male, medicine.medical_specialty, Tuberculosis, India, Rural Health, Risk Assessment, Cost of Illness, Risk Factors, Diabetes mellitus, Environmental health, Epidemiology, Diabetes Mellitus, Prevalence, Humans, Medicine, Sex Distribution, Risk factor, Tuberculosis, Pulmonary, Aged, Tuberculosis in India, business.industry, lcsh:Public aspects of medicine, Incidence, Incidence (epidemiology), Urban Health, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Middle Aged, medicine.disease, Health Surveys, Population Surveillance, Relative risk, Female, Risk assessment, business, Research Article
Abstract: Background Tuberculosis (TB) remains a major cause of mortality in developing countries, and in these countries diabetes prevalence is increasing rapidly. Diabetes increases the risk of TB. Our aim was to assess the potential impact of diabetes as a risk factor for incident pulmonary tuberculosis, using India as an example. Methods We constructed an epidemiological model using data on tuberculosis incidence, diabetes prevalence, population structure, and relative risk of tuberculosis associated with diabetes. We evaluated the contribution made by diabetes to both tuberculosis incidence, and to the difference between tuberculosis incidence in urban and rural areas. Results In India in 2000 there were an estimated 20.7 million adults with diabetes, and 900,000 incident adult cases of pulmonary tuberculosis. Our calculations suggest that diabetes accounts for 14.8% (uncertainty range 7.1% to 23.8%) of pulmonary tuberculosis and 20.2% (8.3% to 41.9%) of smear-positive (i.e. infectious) tuberculosis. We estimate that the increased diabetes prevalence in urban areas is associated with a 15.2% greater smear-positive tuberculosis incidence in urban than rural areas – over a fifth of the estimated total difference. Conclusion Diabetes makes a substantial contribution to the burden of incident tuberculosis in India, and the association is particularly strong for the infectious form of tuberculosis. The current diabetes epidemic may lead to a resurgence of tuberculosis in endemic regions, especially in urban areas. This potentially carries a risk of global spread with serious implications for tuberculosis control and the achievement of the United Nations Millennium Development Goals.
Published: 2007

37. Awareness about diabetes and its complications in the general and diabetic population in a city in southern India

Author: A. Ramachandran, Gojka Roglic, Chamukuttan Snehalatha, R. Shobhana, and Narayanasamy Murugesan
Subjects: Research design, Adult, Male, medicine.medical_specialty, Health Knowledge, Attitudes, Practice, Urban Population, Low education, Endocrinology, Diabetes and Metabolism, Population, MEDLINE, India, Diabetes Complications, Endocrinology, Level of consciousness, Diabetes mellitus, Surveys and Questionnaires, Internal Medicine, medicine, Diabetes Mellitus, Humans, education, Aged, education.field_of_study, business.industry, Indian population, General Medicine, Awareness, Middle Aged, medicine.disease, Physical therapy, Educational Status, Female, business, Demography, Patient education
Abstract: The study was done to find out the levels of awareness on diabetes in urban adult Indian population and to identify factors that influenced the awareness, including presence of diabetes.In population agedor =20 years (n=3681, M=1769, F=1912), details regarding awareness about diabetes in relation with physical activity, healthy and unhealthy diet, causes, symptoms, prevention, complications and measures to improve health were collected using a questionnaire. A high total score indicated good knowledge. Influence of age, gender, educational status, occupation and presence of diabetic history was analysed.Fifty percent of subjects scored less than 15. Maximum scored was 51/65. The median total score was 16. Total score was significantly lower in women than in men (15.0 versus 17.0, p0.0001). Educational status was low in women. Higher education (16.0 versus 12.0, p0.0001) and professional or executive jobs (17.0 versus 15.0, p0.0001) were significantly associated with better awareness. Age had no influence. Knowledge regarding causes of diabetes, its prevention and the methods to improve health was significantly low among the general population. Diabetic subjects had better knowledge about symptoms of diabetes and the preventive aspects.The low median score indicated that the awareness was generally poor. The score was low especially in women and subjects with low education. The study highlights the urgent need for strategies to spread awareness about diabetes in the general population. Diabetic subjects also required better education on many aspects.
Published: 2006

38. Diabetes and associated disorders in Cambodia: two epidemiological surveys

Author: Serey Seng, Lim Keuky, Touch Khun, Gojka Roglic, Michel Pinget, and Hilary King
Subjects: Gerontology, Adult, Blood Glucose, Male, Rural Population, medicine.medical_specialty, Comorbidity, Impaired glucose tolerance, Age Distribution, Environmental health, Diabetes mellitus, Epidemiology, medicine, Diabetes Mellitus, Prevalence, Humans, Obesity, Sex Distribution, Aged, Estimation, business.industry, Public health, General Medicine, Anthropometry, Middle Aged, medicine.disease, Blood pressure, Hypertension, Female, business, Cambodia, Epidemiologic Methods
Abstract: Summary Background The Asia-Pacific region is thought to be severely affected by diabetes. However, reliable, standardised data on prevalence and characteristics of glucose intolerance in Asian populations remain sparse. We describe the results of two field surveys undertaken in Cambodia in 2004. Methods 2246 randomly selected adults aged 25 years and older were examined in two communities, one rural (Siemreap) and one semi-urban (Kampong Cham). The diagnosis of diabetes and impaired glucose tolerance was based on 2-h blood glucose estimation using criteria recommended by the latest report of a WHO Expert Group. Blood pressure, anthropometry, habitual diet, and other relevant characteristics were also recorded. Findings Prevalence of diabetes was 5% in Siemreap and 11% in Kampong Cham. Prevalence of impaired glucose tolerance was 10% in Siemreap and 15% in Kampong Cham. About two-thirds of all cases of diabetes were undiagnosed before the survey. Prevalence of hypertension was 12% at Siemreap and 25% at Kampong Cham. People in Kampong Cham had higher estimates of central obesity than those in Siemreap. Interpretation Diabetes and hypertension are not uncommon in Cambodia. A quarter of all adults in the chosen suburban community had some degree of glucose intolerance. Since Cambodian society is relatively poor, and lifestyle is fairly traditional by international standards, these findings are unexpected.
Published: 2005

39. The burden of mortality attributable to diabetes: realistic estimates for the year 2000

Author: Gojka, Roglic, Nigel, Unwin, Peter H, Bennett, Colin, Mathers, Jaakko, Tuomilehto, Satyajit, Nag, Vincent, Connolly, and Hilary, King
Subjects: Europe, Models, Statistical, Africa, North America, Diabetes Mellitus, Humans, World Health Organization
Abstract: To estimate the global number of excess deaths due to diabetes in the year 2000.We used a computerized generic formal disease model (DisMod II), used by the World Health Organization to assess disease burden through modeling the relationships between incidence, prevalence, and disease-specific mortality. Baseline input data included population structure, age- and sex-specific estimates of diabetes prevalence, and available published estimates of relative risk of death for people with diabetes compared with people without diabetes. The results were validated with population-based observations and independent estimates of relative risk of death.The excess global mortality attributable to diabetes in the year 2000 was estimated to be 2.9 million deaths, equivalent to 5.2% of all deaths. Excess mortality attributable to diabetes accounted for 2-3% of deaths in poorest countries and over 8% in the U.S., Canada, and the Middle East. In people 35-64 years old, 6-27% of deaths were attributable to diabetes.These are the first global estimates of mortality attributable to diabetes. Globally, diabetes is likely to be the fifth leading cause of death.
Published: 2005

40. Screening for Diabetes Mellitus - the World Health Organization Perspective

Author: Gojka Roglic, Rhys Williams, and Stephen Colagiuri
Subjects: Gerontology, medicine.medical_specialty, Endocrinology, business.industry, Diabetes mellitus, Internal medicine, Perspective (graphical), medicine, Type 2 diabetes, medicine.disease, business, World health
Published: 2005
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41. Glucose intolerance and associated factors in the multi-ethnic population of the United Arab Emirates: results of a national survey

Author: B. Abi Saab, Hilary King, M. Malik, A. Bakir, and Gojka Roglic
Subjects: Adult, Blood Glucose, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Population, United Arab Emirates, Overweight, Endocrinology, Diabetes mellitus, Internal medicine, Epidemiology, Glucose Intolerance, Internal Medicine, Ethnicity, Prevalence, Medicine, Humans, Obesity, education, education.field_of_study, business.industry, Insulin, Public health, General Medicine, medicine.disease, Health Surveys, Blood pressure, medicine.symptom, business
Abstract: Aims: To determine the prevalence of diabetes and impaired fasting glycaemia (IFG) and associated conditions such as obesity and hypertension, in the multi-ethnic, adult population of the United Arab Emirates in 1999–2000. Methods: A stratified, multistage, random sample was selected. Diagnosis was based on the latest recommendations of a WHO Expert Group. Results: The overall response rate was 89%. Crude prevalence of diabetes was 20%. It was higher in UAE citizens (25%) than in expatriates (13–19% depending on country of origin). Prevalence of diabetes rose with age to a maximum of 40% after the age of 55 years. Prevalence of impaired fasting glycaemia was 5% in men and 7% in women. Forty-one percent of subjects with diabetes were undiagnosed prior to the survey. Of the previously diagnosed subjects with diabetes, 59% were taking oral hypoglycaemic agents, 8% used insulin and 17% relied on diet alone. Obesity was common in all ethnic groups. Approximately three-quarters of all subjects were either obese (BMI ≥ 30) or overweight (BMI 25–29). Presence of diabetes was associated with increasing waist–hip ratio (WHR), age and with systolic blood pressure and ethnicity. Co-morbidity with glucose intolerance occurred with obesity in 8% and with hypertension in 5%. Three-quarters of all subjects had one or more of these conditions. Conclusions: Diabetes, obesity and hypertension are extremely prevalent in the adult population of the UAE. Prompt action is required to avert a major public health crisis due to the long-term complications of diabetes in the near future.
Published: 2004

42. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030

Author: Sarah, Wild, Gojka, Roglic, Anders, Green, Richard, Sicree, and Hilary, King
Subjects: Adult, Male, Age Distribution, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diabetes Mellitus, Prevalence, Humans, Female, Global Health, World Health Organization
Abstract: The goal of this study was to estimate the prevalence of diabetes and the number of people of all ages with diabetes for years 2000 and 2030.Data on diabetes prevalence by age and sex from a limited number of countries were extrapolated to all 191 World Health Organization member states and applied to United Nations' population estimates for 2000 and 2030. Urban and rural populations were considered separately for developing countries.The prevalence of diabetes for all age-groups worldwide was estimated to be 2.8% in 2000 and 4.4% in 2030. The total number of people with diabetes is projected to rise from 171 million in 2000 to 366 million in 2030. The prevalence of diabetes is higher in men than women, but there are more women with diabetes than men. The urban population in developing countries is projected to double between 2000 and 2030. The most important demographic change to diabetes prevalence across the world appears to be the increase in the proportion of people65 years of age.These findings indicate that the "diabetes epidemic" will continue even if levels of obesity remain constant. Given the increasing prevalence of obesity, it is likely that these figures provide an underestimate of future diabetes prevalence.
Published: 2004

43. 40(th) EASD Annual Meeting of the European Association for the Study of Diabetes : Munich, Germany, 5-9 September 2004

Author: S. Artigas, A V Dreval, Mark I. McCarthy, C Watson, Peter H. Bennett, M Quint, Y Ikeda, E Alpert, F Schiele, H Sekihara, Erik Gylfe, P Lowe, J Kuhlmann, Alain Golay, V Longo, Shahidul Alam Khan Akm., L G Mantovani, M Zawodniak-Szalapska, G Winkler, T Harrity, L Virág, U Johne, Kuo S-W., Linda C Tapsell, J Rodriguez, Michel Komajda, K Kankova, Carole A. Cull, M Sporna, E Estilles, U Ribel, M C Spruce, E Buzzigoli, T Prazak, J K McLaughlin, M K Lingohr, M Lim, F Calara, A Siebenhofer, G Meregalli, Roberto Anichini, A D Baron, R Kurashvili, P C Butler, G I Fantus, T. E. De Gooyer, Park Y-M., R. Walther, S Heinrich, Agnieszka Zawiejska, S Mukherjee, Nikolaos Papanas, G Wong, Ian D. Caterson, David M. Maahs, Shuichi Kaneko, Alexandra E. Butler, Francisco Javier Ampudia-Blasco, O N Kong, Attali J-R., C A Hedman, K Oshinyemi, Nicolle Müller, I C Cranston, N Okumus, M V Vlaiculescu, Balasubramanian Ravikumar, W W Cheatham, K Mukasa, K B Biswas, Annunziata Lapolla, Phil McEwan, G Mader, Gilles Chassot, Dragi Anevski, Werner A. Scherbaum, M Donath, C Hesselmann, R A Gandhi, David E. Moller, Ezio Bonifacio, C Garcia, V Ifandi, P Hornnes, Nieuwenhoven Fav., C Puech, S Pérez-Del-Pulgar, Kim S-R., G Hines, C Rubio Terrés, Michael Gaster, N. Hosszufalusi, A Scholze, Andrew A. Young, Stavros Liatis, F Hariri, S Tan, Paul Valensi, Allan E. Karlsen, J Kim, E. Moberg, J Kaiser, L Berman, G Nelson, A Altkrüger, P Kothare, D B Cook, S Doran, G. van Dijk, Shahnaz Shahinfar, Kim C-S., P Stahl, M Manousaki, S Sigrist, S K Lim, M. P. Stern, A Guberti, C Rezzani, J McKenney, Karl Thomaseth, Sofia Carlsson, M Julia, R Brillante, I Rubesova, T Darkow, E Matsumoto, Wendy M. Macfarlane, M Di Martino, G Bardini, Rossella Menghini, D Duhot, E Farcasiu, Annalisa Natalicchio, I Lindner, J Buvat, Christian L. Brand, Harry Dorchy, Iwona Pietrzak, Z T Luo, P Home, M Ekelund, Jesper Gromada, Kristine Færch, F Piarulli, H Kim, R Mentel, Zsuzsanna K. Zsengellér, Dullaart Rpf., Anton Luger, Thomas A. Pearson, V Manicardi, P Rösen, Feng Y-M., R Morganti, Lars Hansen, Demuth H-U., Haruo Kasai, A Shostak, Rudi Steffensen, G Taylor, Markolf Hanefeld, C Santini, E Hamaguchi, Roberto Miccoli, F Storms, M Cooper, Y Lee, Allison E. Aiello, P Smith, T Suehiro, K Treece, M Waluś, Timothy A Welborn, Simone Baltrusch, E Kontela, S Chai, J Crean, H Yokoyama, Johan G. Eriksson, Rafael Hernández Hernández, J Rodríguez-Saldaña, M P Tornero, G Formoso, D. Lovell, E Bingham, A Mylonakis, M Manteghetti, D Fedele, Antonio Martín-Duce, Ralph A. DeFronzo, D Salcedo, Kurt Højlund, Antonio Petrone, Sheu Whh., C Gutierrez, Flavia Pricci, S Kurita, Z G Abbas, M M Benedetti, Philippe A. Halban, Daniel J. Cox, O Ljungkvist, Justine Davies, J Palsgaard, Lars Sjöström, E Bosi, L Janin-Manificat, W. F. Kelly, M. Fernandez, E Colak, O V Mulyarchik, B Kronshage, F Lang, M Erfurth, Takashi Kadowaki, N Jendrike, U Walter, J Wishart, Y. Neye, D Kim, N Furuhashi, M Barsotti, D Florow, L Ke, L Borgquist, N C Jackson, Ffolliott M. Fisher, V Baskar, K Yoshioka, Bryan A. Wolf, G Chabrier, R Skoumal, Livio Luzi, H Kose, I Pharisien, B. Klein, H Winiarska, M C Johnson, L Griffiths, Nonna Kravchun, C Combe, Baptist Gallwitz, J Zdychova, L Skorda, Jorma Ilonen, W Gao, I N Steen, A Terrinoni, P D Ambery, W Kern, C M Kusminski, Cho M-H., Paolo Pozzilli, Louise G. Grunnet, E Schönle, David R Matthews, Robert W. Taylor, Y Cohen, Kim H-S., M P Eccles, N B Tutuncu, D McDowell, Richard M. Bergenstal, K Takamatsu, T Steiner, Jaan Palgi, Valdemar Grill, N Niculescu, G Federici, S Lehto, P. M. McKeigue, M Barone, Michael E. Trautmann, S Smirnov, J Mannion, M Eto, C Rousseau, M Conti, C S Ernest, Antonio Ceriello, D H Schweitzer, Jung E-D., Andreas Festa, Avijit Lahiri, A Shepelkevich, A Murro, A Kollmann, Jonathan R.S. Arch, R Landgraf, Son H-Y., I Engelsberger, E Agardh, S Rodríguez-Mulero, P J Kraml, K Lee, D. F. Du Toit, E Kim, G Fadini, Williams Ajk., Philip Home, M B Antcieferov, C Perlemoine, D Perrea, Song X-L., D Ruggieri, Krister Bokvist, Heidi Sørensen, Bilbao, G Yoshino, J P Taylor, Shen H-M., S M Furier, R Urquhart, J Wohlgelernter, Jianping Weng, T. Baba, Q Hong, C Silva, Castaigne J-P., M Felaco, X X Zhang, M Jaroň, Milla Rosengård-Bärlund, J G Papp, Toshio Miyata, Lervang H-H., Park M-K., I Kinalska, A Long, Oomen Phn., N Kogawa, Ippolita Patrizia Patera, S. Karadeniz, Dinesh Selvarajah, D S Chung, A Wensaas, Richard Imrich, M Recasens, J Ruxer, O Buchea, E Wilpart, S P Stepanenko, Le Ttd., H Ohgawara, Mariaconsuelo Valentini, A Mondok, M Peltonen, Marianne O. Larsen, K Chatzianagnostou, Agneta Ståhle, A L Ferrari, L Bordier, F Maingrette, A Matsuda, G Vukomanovic, Jakob D. Wikstrom, T Yamakita, E Gorostiaga, J Jin, B Gopalan, Heinz Drexel, S Hewitt, Rury R. Holman, C Dieterle, T L Ruchti, N Asatiani, M Sidira, A Iezzi, A J Sommerfield, D Châtenet, M L Olsen, R Bergemann, C Koehler, T L Kuraeva, B Balas, Christian Berne, E Santos-Mazo, G Smith, A Siejka, R Kožnarová, A Mattina, S Sheikh, A Adomeit, M Rasmussen, J. Fagerudd, N Busciantella Ricci, Nuria Vilarrasa, E Hammar, T L Thoms, L Aydın, Ron G. Rosenfeld, A Nikolajuk, R Gos, C L Morgan, H L Yu, D Dheelchand, S Ramrath, N Boudriga, Jerome I. Rotter, C Jahannault, W M Weston, Folke Lindgärde, M Hertlova, D Knight, A Monroy-Mayorga, E Pardini, A Chamson-Reig, B Franke, Janie McCluskey, Joseph Bryan, C Nikolopoulou, Christie M. Ballantyne, Fausto Santeusanio, L Pegoraro, M Lee, A Klimenko, S Jaiveer, K. Pettersson-Fernholm, Michael A. Nauck, A Ekbom-Schnell, G Deferrari, Riccardo Schiaffini, S. Pampanelli, Khan Aka., David Hopkins, Maija Wessman, M Kamarinos, Noh J-H., O Ebisui, K McCarroll, Jeppe Sturis, Peter Nowotny, N Gorbenko, Åke Sjöholm, David G. Maggs, A E Halseth, B Cresci, A A Ortiz-Gress, A Korakovouni, O Matejkova, C E Mogensen, C J Lin, Ramon Gomis, H Seaman, C Granier, Yang C-H., F Assah, O Sanchez, Fausto Machicao, Peter G. Morris, Alberto Ortiz, A Giardinelli, D Bracaglia, A Gonzalo, S Pavlatos, Andreas Lechner, F Canovic, L Sjolind, Allan Vaag, Birgitte Bruun Nielsen, David A. Ziegler, Vito Lampasona, R Gershoni-Baruch, A. Dei Cas, H Renz, E Mena, Matthew Waltham, Kim D-M., H Levanen, D D Mick, Valentina Alexandrovna Peterkova, E Meskhishvili, Sarah Nutland, R Bustani, John R. 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S, Choi, D, Kim, N, Matsumoto, S, Suetsugu, M, Matsutomo, R, Pisarczyk wiza, D, Banaszak, A, Wysocki, H, Usui, H, Shikata, K, Okada, S, Ogawa, D, Yozai, K, Kido, Y, Nagase, R, Ohga, S, Tone, A, Sasaki, M, Wada, J, Unno, Y, Horiuchi, S, Mclennan, S, Kamarinos, M, Waltham, M, Dy, V, Yue, D, Zdychova, J, Komers, R, Cresci, B, Giannini, S, Manuelli, C, Giunti, S, Pinach, S, Ianni Palarchio, A, Arnaldi, L, Vittone, F, Camussi, G, Cavallo Perin, P, Gruden, G, Marshall, S, Jones, S, White, K, Brizzi, M, Dentelli, P, Rosso, A, Calvi, C, Gambino, R, Cassader, M, Salvidio, G, Deferrari, G, Pegoraro, L, Pagano, G, Cavallo perin, P, Oates, R, Ellery, C, Beebe, D, Coutcher, J, Qian, Y, Lowe, V, Appleton, T, Raunig, D, O'Neil, S, Mylari, B, Amazonas, R, Fujita, A, Doi, A, Matsuno, S, Okamoto, K, Matsumoto, E, Furuta, H, Nishi, M, Tsuno, T, Taniguchi, H, Bessho, H, Wasén, E, Isoaho, R, Mattila, K, Vahlberg, T, Kivelä, S, Irjala, K, Rigalleau, V, Lasseur, C, Perlemoine, C, Barthes, N, Raffaitin, C, 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Jensen, G, Fisher, A, Petrovsky, N, Srikusalanukul, W, Budge, M, Trifunovic zamaklar, D, Zivkovic, M, Jelic, V, Vukomanovic, G, Ristic, A, Seferovic, P, Costa, J, Duarte, S, Manley, S, Sailesh, S, Venkataraman, A, Haider, Y, Groza, I, Oprean, M, Ardelean, A, Morosanu, A, Darkow, T, Vanderplas, A, Mamas, M, Mcelduff, P, Burns, J, Edwards, R, Fitchet, A, Young, R, Gibson, J, Lichiardopol, R, Niculescu, N, Totora, A, Pencea, C, Tomescu, I, Cinteza, M, Manicardi, V, Coscelli, C, Navazio, A, Catellani, E, Michelini, M, Dall'Asta, D, Guberti, A, Piazza, A, Gasparini, E, Pantaleoni, M, Guiducci, U, Manari, A, Sejil, S, Janand delenne, B, Avierinos, J, Habib, G, Labastie, N, Vague, P, Lassmann vague, V, Luźniak, P, Tatoń, J, Wojciechowska Luźniak, A, Zairis, M, Lyras, A, Patsourakos, N, Tsirimbis, V, Foussas, S, Lupón, J, Urrutia, A, Herreros, J, González, B, Coll, R, Altimir, S, Prats, M, Valle, V, Abreu padí, C, Rábago, G, Ivanova, L, Brasacchio, D, Harno, E, Keenan, A, Li, H, Lu, Z, Ke, L, Liu, H, Jeong, I, Chae, M, Choi, M, Yoo, H, Kim, C, Yun, M, Na, M, Kang, Y, Kong, O, Son, S, Kim, I, Tanaka, N, Hosoi, M, Matsuyama, Y, Fukumoto, M, Yamakita, T, Yoshioka, K, Ishii, T, Sato, T, Fujii, S, Aoki, T, Shibata, T, Mizutani, N, Suzuki, J, Fowelin, J, Samuelsson, P, Brandrup wogsen, G, Okumura, K, Tokmakova, A, Staroverova, D, Antcieferov, M, Shutichina, I, Kuntchevich, G, Vriesendorp, T, Morélis, Q, Legemate, D, Schaper, F, Mainas, E, Gkioulmpasanis, I, Panagiotou, I, Vassilikos, G, Skorda, L, Sidira, M, Christoforidou, M, Alaveras, A, Artikis, V, Evdemon, E, Lechleitner, M, Koch, T, Ebenbichler, C, Sturm, W, Moretti, L, Moruzzo, D, Boldrini, E, Pandolfo, C, Kameyama, M, Iwasa, R, Cho, M, Nam, J, Huh, K, Kaplar, M, Paragh, G, Erdei, A, Csongradi, E, Garai, I, Varga, J, Galuska, L, Udvardy, M, Higa, M, Kaneko, Y, Hiroi, N, Koziarska, D, Nowacki, P, Majkowska, L, Luzniak, P, Wojciechowska luźniak, A, Tushuizen, M, Nieuwland, R, Snoeck, D, Sturk, A, Diamant, M, Aguiar, L, Bahia, 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D, Torjesen, P, Kilhovd, B, Berg, T, Sandvik, L, Hanssen, K, Mentink, C, Donchenko, G, Stepanenko, S, Maingrette, F, Deng, H, Lindenmair, A, Freudenthaler, A, Baumgartner parzer, S, Nizheradze, K, Khoruzhenko, A, Tronko, N, Sheu, W, Ou, H, Shen, H, Lin, T, Wu, H, Yang, C, Mogylnytska, L, Schmoelzer, I, Davies, J, Band, M, Struthers, A, Prázný, M, Škrha, J, Kasalová, Z, Neelotpol, S, Jahan, P, Kauschke, S, Harrop, C, Schäfer, A, Widder, J, Eigenthaler, M, Walter, U, Uchimura, I, Ikebukuro, M, Kaibara, M, Hirata, M, Helal, R, Pervin, F, Yang, X, Jansson, P, Nagaev, I, Jack, M, Carvalho, E, Sunnerhagen, K, Cam, M, Cushman, S, Smith, U, Creely, S, Farmer, J, Gustafson, B, Kusminski, C, Krusinova, E, Wohl, P, Klementova, M, Lanska, V, Mcdougall, C, Kelly, I, Abbas, Z, Lutale, J, Archibald, L, Karunajeewa, H, Stingemore, N, Stuccio, G, Mcgechie, D, Muller, L, Hak, E, Goudzwaard, W, Montorsi, F, Homering, M, Sprenger, K, Goldstein, I, Asnaghi, V, Ferrari, G, Rastaldi, M, Gabellini, D, Dell'Antonio, G, Maestroni, A, Ruggieri, D, Luzi, L, Piemonti, L, Zerbini, G, Anafaroglu, I, Tutuncu, N, Sultana, M, Siddiqua, N, Iwasaki, T, Nakajima, A, Yoneda, M, Mukasa, K, Tanaka, S, and Sekihara, H
Subjects: 0303 health sciences, medicine.medical_specialty, business.industry, EASD, Endocrinology, Diabetes and Metabolism, Human physiology, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, Family medicine, Internal Medicine, Medicine, business, 030217 neurology & neurosurgery, 030304 developmental biology
Published: 2004

44. The Middle East

Author: Hilary King, Gojka Roglic, and Ala'din Alwan
Published: 2003
Full Text: View/download PDF

45. Diabetes mellitus in Asia

Author: Gojka Roglic and King H
Subjects: Adult, Asia, Diabetes Mellitus, Type 1, Adolescent, Diabetes Mellitus, Type 2, Hong Kong, Humans, Child
Published: 2000

46. [National organization of health care in diabetes based on the 'Croatian model']

Author: Metelko Z, Sestan-Crnek S, Babić Z, Gojka Roglic, Pavlić-Renar I, Granić M, and Skrabalo Z
Subjects: Croatia, Diabetes Mellitus, Prevalence, Humans, Registries, Health Services, Health Services Administration, Medical Records
Abstract: This review article shows the development and organization of the "Croatian Model" of organization of health care for diabetic patients from Professor Vuk Vrhovac to this day, and its inclusion in the St. Vincent Declaration-a group of recommendations agreed upon in 1989 with the aim to decrease the morbidity and mortality of diabetes and its complications. The Model is organized on primary, secondary and terciary levels of health care. After the administrative changes of 1993, specialized health care for diabetic patients is delivered through County and Regional Centres for Diabetes and the Diabetes Reference Centre (the Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases), a scientific and educational institution and a WHO Collaborating Centre. Mention is made of the Croatian Diabetes Registry and statistical data on the morbidity (the prevalence of diabetes in Croatia is 2.37%) and mortality of diabetes mellitus and its complications, of organization of health care for diabetic patients, their medical treatment and care in Croatia.
Published: 1996

47. Diabetes in time of armed conflict: the Croatian experience

Author: Metelko Z, Gojka Roglic, and Skrabalo Z
Subjects: Adult, Male, Warfare, Adolescent, Croatia, Incidence, Population Dynamics, Middle Aged, Child, Preschool, Data Interpretation, Statistical, Diabetes Mellitus, Humans, Female, Child, Stress, Psychological, Demography
Abstract: During the summer of 1991, armed conflict broke out in the Republic of Croatia. This resulted in many deaths and the displacement of many persons, with population loss in some communities and additional population burden in others. Registration of diabetic persons has been compulsory in Croatia since 1975 and from available statistics compiled by the Vuk Vrhovac Institute for Diabetes in Zagreb it was known that in 1991 there were 111,096 diabetic persons in Croatia, 16% requiring insulin, 46% treated with oral agents and 38% using dietary treatment only. This information helped to plan adequate supplies during the emergency. Contacts with international organizations and friends were of value in overcoming shortages, the most useful gifts being battery-operated blood glucose measuring devices. A study in Zagreb failed to demonstrate an association between the stress of displacement and metabolic control. Somewhat unexpectedly, diabetes and its complications did not present a major public health problem during the first 8 months of the armed conflict, but the long-term effects of these events remain to be seen.

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