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Additional file 2. Theories and concepts used in the design of the Targeted Client Communication (TCC) intervention

Operationalization of variables. Detailed presentation of the operationalization of candidate predictors considered for analysis not included in the full model. (PDF 220 kb)

Predictor selection procedure. Presentation of the step-by-step procedure used for identifying candidate predictors and selecing the final predictors included in the prognostic model. (PDF 152 kb)

The prevalence of and risk factors for diabetic peripheral neuropathy among type 2 diabetic outpatients in Bangladesh Author: Kjersti Mørkrid Supervisors: Akhtar Hussain, Liaquat Ali Aims/hypothesis: The purpose of the study was to estimate the prevalence and risk factors for diabetic peripheral neuropathy (DPN), and additionally, evaluate the sensory and musculoskeletal lower-leg function, in type 2 diabetic outpatients, attending the BIRDEM hospital in Bangladesh. Materials and methods: Type 2 diabetic outpatients, diagnosed 5-11 years prior the investigation was randomly drawn. The Neuropathy Symptom Score (NSS) and the Neuropathy Disability Score (NDS) was employed to assess DPN. Data about socio-demographic characters, blood pressure, height, weight, waist and hip circumference, and random blood and urine samples were collected. For the lower-leg function evaluation, the plantar cutaneous sensation (Semmer-Weinstein 5.07 g monofilament), 1st MTP and ankle joint rang of motion (ROM) (goniometry) and muscle function (Kendall’s muscle test) in addition to balance (one and two leg static balance, tandem walk) was examined. Results: Two hundred and ninety four (139 men, 155 women) type 2 diabetic outpatients were studied. The overall DPN prevalence was 19.7 %, male (20.9%) and female (18.7 %). The prevalence rate increased with increasing age (from 11.1% in the 23-40 year-old group to 32.3% in the 60-80 year-old group) and duration of diabetes (from 14.1% in patients with 5 years to 29.2% in patients with 9-11 years duration). Age > 60 years (OR 4.2, 95% CI 1.4 – 12.3), low/normal WHR (OR 3.8, 95%CI 1.6-9.3), treatment with insulin (OR 2.0, 95% CI 1.0-4.0) and income < 800 TK (OR 3.1, 95% CI 1.1-9.3) were independent, statistically significant risk factors for the occurrence of DPN, longer duration of diabetes (OR 1.2, 95% CI 1.0-1.4) and higher HbA1c (OR 1.1, 95% CI 1.0-1.3) were independent, borderline statistically significant risk factors for DPN. The 1st MTP dorsal (p=0.03) and plantar flexion (p=0.003) joint ROM, the Tibialis anterior (p=0.03) and Flexor hallucis (p=0.02) strength, balance (

Aims/hypothesis: The purpose of the study was to estimate the prevalence and risk factors for diabetic peripheral neuropathy (DPN), and additionally, evaluate the sensory and musculoskeletal lower-leg function, in type 2 diabetic outpatients, attending the BIRDEM hospital in Bangladesh. Materials and methods: Type 2 diabetic outpatients, diagnosed 5-11 years prior the investigation was randomly drawn. The Neuropathy Symptom Score (NSS) and the Neuropathy Disability Score (NDS) was employed to assess DPN. Data about socio-demographic characters, blood pressure, height, weight, waist and hip circumference, and random blood and urine samples were collected. For the lower-leg function evaluation, the plantar cutaneous sensation (Semmer-Weinstein 5.07 g monofilament), 1st MTP and ankle joint rang of motion (ROM) (goniometry) and muscle function (Kendall’s muscle test) in addition to balance (one and two leg static balance, tandem walk) was examined. Results: Two hundred and ninety four (139 men, 155 women) type 2 diabetic outpatients were studied. The overall DPN prevalence was 19.7 %, male (20.9%) and female (18.7 %). The prevalence rate increased with increasing age (from 11.1% in the 23-40 year-old group to 32.3% in the 60-80 year-old group) and duration of diabetes (from 14.1% in patients with 5 years to 29.2% in patients with 9-11 years duration). Age > 60 years (OR 4.2, 95% CI 1.4 – 12.3), low/normal WHR (OR 3.8, 95%CI 1.6-9.3), treatment with insulin (OR 2.0, 95% CI 1.0-4.0) and income < 800 TK (OR 3.1, 95% CI 1.1-9.3) were independent, statistically significant risk factors for the occurrence of DPN, longer duration of diabetes (OR 1.2, 95% CI 1.0-1.4) and higher HbA1c (OR 1.1, 95% CI 1.0-1.3) were independent, borderline statistically significant risk factors for DPN. The 1st MTP dorsal (p=0.03) and plantar flexion (p=0.003) joint ROM, the Tibialis anterior (p=0.03) and Flexor hallucis (p=0.02) strength, balance (

Additional file 1. The timing and services provided according to the Palestinian national antenatal guidelines and the corresponding high-risk conditions addressed in the tailored Targeted Client Communication (TCC) intervention

Additional file 1. The timing and services provided according to the Palestinian national antenatal guidelines and the corresponding high-risk conditions addressed in the tailored Targeted Client Communication (TCC) intervention

Additional file 1. List of participating clinics and allocation

Additional file 2. Oral informed consent and interview guide

Background Maternal glucose and lipid levels are associated with neonatal anthropometry of the offspring, also independently of maternal body mass index (BMI). Gestational weight gain, however, is often not accounted for. The objective was to explore whether the effects of maternal glucose and lipid levels on offspring’s birth weight and subcutaneous fat were independent of early pregnancy BMI and mid-gestational weight gain. Methods In a population-based, multi-ethnic, prospective cohort of 699 women and their offspring, maternal anthropometrics were collected in gestational week 15 and 28. Maternal fasting plasma lipids, fasting and 2-hour glucose post 75 g glucose load, were collected in gestational week 28. Maternal risk factors were standardized using z-scores. Outcomes were neonatal birth weight and sum of skinfolds in four different regions. Results Mean (standard deviation) birth weight was 3491 ± 498 g and mean sum of skinfolds was 18.2 ± 3.9 mm. Maternal fasting glucose and HDL-cholesterol were predictors of birth weight, and fasting and 2-hour glucose were predictors of neonatal sum of skinfolds, independently of weight gain as well as early pregnancy BMI, gestational week at inclusion, maternal age, parity, smoking status, ethnic origin, gestational age and offspring’s sex. However, weight gain was the strongest independent predictor of both birth weight and neonatal sum of skinfolds, with a 0.21 kg/week increased weight gain giving a 110.7 (95% confidence interval 76.6-144.9) g heavier neonate, and with 0.72 (0.38-1.06) mm larger sum of skinfolds. The effect size of mother’s early pregnancy BMI on birth weight was higher in non-Europeans than in Europeans. Conclusions Maternal fasting glucose and HDL-cholesterol were predictors of offspring’s birth weight, and fasting and 2-hour glucose were predictors of neonatal sum of skinfolds, independently of weight gain. Mid-gestational weight gain was a stronger predictor of both birth weight and neonatal sum of skinfolds than early pregnancy BMI, maternal glucose and lipid levels.

Additional file 1. List of participating clinics and allocation

Additional file 2. Oral informed consent and interview guide