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Epidemiology
Writer
Institution
Epidemiology
Diabetes, on of the most common type of disease which is spreading by leaps and bounds. Most of the people are suffering from diabetes. In fact, Type 2 diabetes is what people are being suffered from all over the world. What makes it most common is the life-style people have endured throughout the world. Rapid westernization has played a due part in the spread of this disease, and the disease has increased dramatically in people owing to their rapid westernization. The most important measures concerning diabetes and especially Type 2 diabetes are the preventive measures and the risk factors which have made people vulnerable to this disease ADDIN ZOTERO_ITEM CSL_CITATION citationIDzvktULvv,propertiesformattedCitation(Andersen, Christiansen, Andersen, Kreiner, Deckert, 1983),plainCitation(Andersen, Christiansen, Andersen, Kreiner, Deckert, 1983),noteIndex0,citationItemsid179,urishttp//zotero.org/users/local/jsvqEXt1/items/5NTGIL6R,urihttp//zotero.org/users/local/jsvqEXt1/items/5NTGIL6R,itemDataid179,typearticle-journal,titleDiabetic nephropathy in type 1 (insulin-dependent) diabetes An epidemiological study,container-titleDiabetologia,volume25,issue6,sourceDOI.org (Crossref),abstractSummary. A follow-up of 1475 Type 1 (insulin-dependent) diabetic patients diagnosed before 1953 (815males, 660females) and before the age of 31 years was conducted. All patients Were seen at the Steno Memorial Hospital and were referred from all parts of Denmark 91 (6) could not be traced. The rest (94) were followed until death or for at least 25 years 249 (17) were followed for 40years. Clinical diabetic nephropathy developed in 531 (41) of the 1303 patients in whom sufficient information was available regarding proteinuria. Other causes of proteinuria were found in 3, and 57 did not develop persistent proteinuria. The prevalence of diabetic nephropathy was 21 after 20-25 years of diabetes duration followed by a decline to 10 after 40 years. Two incidence peaks of the onset of proteinuria were seen, one after 16 and another after 32 years duration of diabetes. Incidence increased steeply 10 years after onset of diabetes and was low after 35 years duration. The cumulative incidence was 45 after 40 years of diabetes. A male preponderance was seen among patients with nephropathy. A significant difference in the pattern of annual incidence rates of diabetic nephropathy was seen, when groups with onset of diabetes before 1933, between 1933-1942, and 1943-1952, respectively, were compared. An association between daily insulin requirement and nephropathy incidence was found. Patients with nephropathy had a much poorer survival than those without proteinuria 40 years after onset of diabetes, only 10 of patients who developed nephropathy were alive, whereas 70 of patients who did not develop nephropathy survived. Uraemia was the cause of death in 66 of the patients with nephropathy 7 years after the onset of persistent proteinuria, 49 of the patients had died. It is concluded that diabetic nephropathy is the major life threatening complication in Type I diabetes of juvenile onset.,URLhttp//link.springer.com/10.1007/BF00284458,DOI10.1007/BF00284458,ISSN0012-186X, 1432-0428,title-shortDiabetic nephropathy in type 1 (insulin-dependent) diabetes,journalAbbreviationDiabetologia,languageen,authorfamilyAndersen,givenA.R.,familyChristiansen,givenJ.Sandahl,familyAndersen,givenJ.K.,familyKreiner,givenS.,familyDeckert,givenT.,issueddate-parts1983,12,accesseddate-parts2019,5,4,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Andersen, Christiansen, Andersen, Kreiner, Deckert, 1983). Diabetic mellitus (DM) is in fact caused by the reduction in insulin secretion, owing to aforementioned statement, it is termed as metabolic disorder. The other type, which is Type 1 of DM, owes annihilation of beta cells autoimmune in the islets of Langerhans. The devastation of beta cell results in a deficit of insulin secretion ADDIN ZOTERO_ITEM CSL_CITATION citationID0LRawlcW,propertiesformattedCitation(Penn et al., 2013),plainCitation(Penn et al., 2013),noteIndex0,citationItemsid166,urishttp//zotero.org/users/local/jsvqEXt1/items/6368D9J2,urihttp//zotero.org/users/local/jsvqEXt1/items/6368D9J2,itemDataid166,typearticle-journal,titleImportance of Weight Loss Maintenance and Risk Prediction in the Prevention of Type 2 Diabetes Analysis of European Diabetes Prevention Study RCT,container-titlePLoS ONE,pagee57143,volume8,issue2,sourceDOI.org (Crossref),abstractBackground Prevalence of type 2 diabetes (T2D) is increasing worldwide. T2D prevention by lifestyle intervention is effective. Pragmatic scalable interventions are needed, with evidence to efficiently target and monitor such interventions. We report pooled analyses of data from three European trial cohorts to analyse T2D incidence, sustained weight loss and utility of risk predictors.nMethods We analysed data on 749 adults with impaired glucose tolerance (278 men and 471 women, mean age 56 years, mean BMI 31 kgm22) recruited between 1993 and 2003, and randomised to intensive lifestyle intervention (I) or lifestyle advice control (C). The intervention aimed to increase physical activity, modify diet, and promote weight loss5. Using Cox-regression survival analysis, we assessed T2D incidence and the impact on T2D incidence of sustained weight loss, and of baseline cut-point values of FINDRISC score, fasting plasma glucose (FPG), and HbA1c.nResults Mean follow-up duration was 3.1 years. T2D was diagnosed in 139 participants (I 45/379, C 94/370). Cumulative T2D incidence was 57 lower in the intervention compared with the control group (HR 0.42 (95 CI 0.29 to 0.60) P,0.001). Participants with 5 weight loss at one year had 65 lower T2D incidence (HR 0.35 (95 CI 0.22 to 0.56) P,0.001) maintaining 5 weight loss for two and three years further reduced T2D incidence. Recommended cut-points to identify those at high risk for T2D would have identified different proportions of European Diabetes Prevention Study (EDIPS) participants with similar hazard-ratios for intervention effect.nConclusions Pooled analysis of EDIPS trial data reinforces evidence for T2D prevention by lifestyle intervention. Analysis showed the preventive effect of 5 weight loss, especially if maintained long term, which has utility for intervention monitoring. Analysis of proposed cut-points demonstrates difficulties in balancing risk and benefit, to efficiently target interventions and suggests evidence is needed to define clinical policy.,DOI10.1371/journal.pone.0057143,ISSN1932-6203,title-shortImportance of Weight Loss Maintenance and Risk Prediction in the Prevention of Type 2 Diabetes,journalAbbreviationPLoS ONE,languageen,authorfamilyPenn,givenLinda,familyWhite,givenMartin,familyLindstrm,givenJaana,familyBoer,givenAnnemieke Th.,non-dropping-particleden,familyBlaak,givenEllen,familyEriksson,givenJohan G.,familyFeskens,givenEdith,familyIlanne-Parikka,givenPirjo,familyKeinnen-Kiukaanniemi,givenSirkka M.,familyWalker,givenMark,familyMathers,givenJohn C.,familyUusitupa,givenMatti,familyTuomilehto,givenJaakko,editorfamilyCasarini,givenDulce Elena,issueddate-parts2013,2,25,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Penn et al., 2013).
International Diabetes Federation states that about 8.8 of worlds population is affected by DM in last two decades. Out of this 8.8, Middle Eastern and North African (MENA)population shows higher frequency of DM compared with other regions. The main cause of such high frequency of diabetes in MENA region owes urbanization in such regions and the departure from their life-style ADDIN ZOTERO_ITEM CSL_CITATION citationIDT712FiMd,propertiesformattedCitation(Penn et al., 2013),plainCitation(Penn et al., 2013),noteIndex0,citationItemsid166,urishttp//zotero.org/users/local/jsvqEXt1/items/6368D9J2,urihttp//zotero.org/users/local/jsvqEXt1/items/6368D9J2,itemDataid166,typearticle-journal,titleImportance of Weight Loss Maintenance and Risk Prediction in the Prevention of Type 2 Diabetes Analysis of European Diabetes Prevention Study RCT,container-titlePLoS ONE,pagee57143,volume8,issue2,sourceDOI.org (Crossref),abstractBackground Prevalence of type 2 diabetes (T2D) is increasing worldwide. T2D prevention by lifestyle intervention is effective. Pragmatic scalable interventions are needed, with evidence to efficiently target and monitor such interventions. We report pooled analyses of data from three European trial cohorts to analyse T2D incidence, sustained weight loss and utility of risk predictors.nMethods We analysed data on 749 adults with impaired glucose tolerance (278 men and 471 women, mean age 56 years, mean BMI 31 kgm22) recruited between 1993 and 2003, and randomised to intensive lifestyle intervention (I) or lifestyle advice control (C). The intervention aimed to increase physical activity, modify diet, and promote weight loss5. Using Cox-regression survival analysis, we assessed T2D incidence and the impact on T2D incidence of sustained weight loss, and of baseline cut-point values of FINDRISC score, fasting plasma glucose (FPG), and HbA1c.nResults Mean follow-up duration was 3.1 years. T2D was diagnosed in 139 participants (I 45/379, C 94/370). Cumulative T2D incidence was 57 lower in the intervention compared with the control group (HR 0.42 (95 CI 0.29 to 0.60) P,0.001). Participants with 5 weight loss at one year had 65 lower T2D incidence (HR 0.35 (95 CI 0.22 to 0.56) P,0.001) maintaining 5 weight loss for two and three years further reduced T2D incidence. Recommended cut-points to identify those at high risk for T2D would have identified different proportions of European Diabetes Prevention Study (EDIPS) participants with similar hazard-ratios for intervention effect.nConclusions Pooled analysis of EDIPS trial data reinforces evidence for T2D prevention by lifestyle intervention. Analysis showed the preventive effect of 5 weight loss, especially if maintained long term, which has utility for intervention monitoring. Analysis of proposed cut-points demonstrates difficulties in balancing risk and benefit, to efficiently target interventions and suggests evidence is needed to define clinical policy.,DOI10.1371/journal.pone.0057143,ISSN1932-6203,title-shortImportance of Weight Loss Maintenance and Risk Prediction in the Prevention of Type 2 Diabetes,journalAbbreviationPLoS ONE,languageen,authorfamilyPenn,givenLinda,familyWhite,givenMartin,familyLindstrm,givenJaana,familyBoer,givenAnnemieke Th.,non-dropping-particleden,familyBlaak,givenEllen,familyEriksson,givenJohan G.,familyFeskens,givenEdith,familyIlanne-Parikka,givenPirjo,familyKeinnen-Kiukaanniemi,givenSirkka M.,familyWalker,givenMark,familyMathers,givenJohn C.,familyUusitupa,givenMatti,familyTuomilehto,givenJaakko,editorfamilyCasarini,givenDulce Elena,issueddate-parts2013,2,25,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Penn et al., 2013).
Scores of researches have been carried out on the epidemiology of diabetes which provide an insight to the common causes and risk factors attached with it. In addition previous researches carry out the anatomy of the disease to delineate the relation between confounding factors coupled with independent factors such as socio-economics, life-style, poor physical health, duration of diabetes, hypertension, age, sex, marital status and the residence of the target population ADDIN ZOTERO_ITEM CSL_CITATION citationIDaY2IFZY7,propertiesformattedCitation(Alanazi et al., 2018),plainCitation(Alanazi et al., 2018),noteIndex0,citationItemsid162,urishttp//zotero.org/users/local/jsvqEXt1/items/ZZY6T7H9,urihttp//zotero.org/users/local/jsvqEXt1/items/ZZY6T7H9,itemDataid162,typearticle-journal,titleKnowledge and awareness of diabetes mellitus and its risk factors in Saudi Arabia,container-titleSaudi Medical Journal,page981-989,volume39,issue10,sourcePubMed Central,abstractObjectivesnTo summarize available peer-reviewed publications about public knowledge and awareness of diabetes mellitus (DM) among the population of Saudi Arabia.nnMethodsnWe followed the standard reporting guidelines outlined in the PRISMA statement for the preparation of this systematic review. In February 2018 we conducted literature searches of PubMed, Scopus, BIOSIS Citation Index, and Web of Science using the following keywords Knowledge OR Awareness AND Diabetes Mellitus AND Saudi Arabia. Records were screened, and relevant studies were selected and synthesized narratively.nnResultsnNineteen articles are included in our systematic review. These studies included the following populations DM patients (n13), healthcare workers (n3), medical students (n1), secondary school students (n1), and general population (n1). Most studies found a lack of public awareness of the risk factors and complications of DM. Among medical students and healthcare workers, knowledge about the epidemiology of the disease and angle of insulin injection was deficient.nnConclusionnThis review highlights the need for increased knowledge and awareness of DM among the Saudi population. The means of improving knowledge and awareness of DM needs to be integrated into existing healthcare systems and processes to better inform patients, families, and communities about this chronic disease., PROSPERO REG. NO CRD 42018098787,DOI10.15537/smj.2018.10.22938,ISSN0379-5284,notePMID 30284579nPMCID PMC6201026,journalAbbreviationSaudi Med J,authorfamilyAlanazi,givenFaisal K.,familyAlotaibi,givenJazi S.,familyPaliadelis,givenPenny,familyAlqarawi,givenNada,familyAlsharari,givenAbdalkarem,familyAlbagawi,givenBander,issueddate-parts2018,10,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Alanazi et al., 2018). The evaluation of cross-sectional study on the awareness and control of this disease is the most essential question to address. Awareness would include all the prevalent causes of the diabetes which have been discussed by the researches carried out on the subject previously. ADDIN ZOTERO_ITEM CSL_CITATION citationID7QUkE3VF,propertiesformattedCitation(Egede Zheng, 2003),plainCitation(Egede Zheng, 2003),noteIndex0,citationItemsid171,urishttp//zotero.org/users/local/jsvqEXt1/items/ND973I2T,urihttp//zotero.org/users/local/jsvqEXt1/items/ND973I2T,itemDataid171,typearticle-journal,titleIndependent Factors Associated With Major Depressive Disorder in a National Sample of Individuals With Diabetes,container-titleDiabetes Care,page104-111,volume26,issue1,sourcecare.diabetesjournals.org,abstractOBJECTIVETo determine whether perceived poor physical health, duration of diabetes, and smoking are associated with major depressive disorder in a national sample of individuals with diabetes.nRESEARCH DESIGN AND METHODSData on 1,810 individuals with diabetes from the 1999 National Health Interview Survey (NHIS) were analyzed. The Composite International Diagnostic Interview (CIDI) Short-Form (CIDI-SF) developed by the World Health Organization was used to identify individuals with major depressive disorder. Multiple logistic regression was used to determine whether perceived poor physical health, duration of diabetes, and smoking were associated with major depressive disorder. The model controlled for age, sex, race/ethnicity, education, income, employment, marital status, and health status. Other control variables included BMI, smoking, duration of diabetes, presence or absence of major complications, and type of treatment for diabetes. SUDAAN software was used for statistical analyses to account for the complex sampling design of NHIS.nRESULTSIndependent factors associated with major depressive disorder were age 64 years, female sex, at least high school education, income 124 of federal poverty level, perceived worsening of health status, and smoking.nCONCLUSIONSIn addition to other psychosocial factors such as younger age, female sex, lower income, at least high school education, and smoking, perceptions about the effect of diabetes on overall health seems to play an important role in the etiology of depression.,DOI10.2337/diacare.26.1.104,ISSN0149-5992, 1935-5548,notePMID 12502665,languageen,authorfamilyEgede,givenLeonard E.,familyZheng,givenDeyi,issueddate-parts2003,1,1,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Egede Zheng, 2003) The main objective of this essay to present a critical appraisal depending upon the studies carried out on the subject matter with different designs, such as cohort case control and RCT study of disease.
Methodology
Literature and previous researches on the subject matter are essential to draw a conclusion following the detailed analysis of the subject matter. The articles which provide a sufficient data were all taken from the google scholar and all three provide a profound acumen to DM, it causes, risk factors involved with it and awareness about the disease. The three research articles selected for analysis were extracted from the Google Scholar. The first article which provides an insight to the case control study of risk factors responsible for the development of Type 2 DM and stresses upon the physical activity as the major cause of the prevalence of DM was picked from Google Scholar. Key words used for the search of this article were Case control studies, type 2 diabetes, dyslipidemia, physical activity. And the article is A case-control study of risk factors for development of Type 2 diabetes Emphasis on physical activity. The study aims to gauge the causes of diabetes concomitant life-style of the population sample. ADDIN ZOTERO_ITEM CSL_CITATION citationID6i7c0329,propertiesformattedCitation(Alanazi et al., 2018),plainCitation(Alanazi et al., 2018),noteIndex0,citationItemsid162,urishttp//zotero.org/users/local/jsvqEXt1/items/ZZY6T7H9,urihttp//zotero.org/users/local/jsvqEXt1/items/ZZY6T7H9,itemDataid162,typearticle-journal,titleKnowledge and awareness of diabetes mellitus and its risk factors in Saudi Arabia,container-titleSaudi Medical Journal,page981-989,volume39,issue10,sourcePubMed Central,abstractObjectivesnTo summarize available peer-reviewed publications about public knowledge and awareness of diabetes mellitus (DM) among the population of Saudi Arabia.nnMethodsnWe followed the standard reporting guidelines outlined in the PRISMA statement for the preparation of this systematic review. In February 2018 we conducted literature searches of PubMed, Scopus, BIOSIS Citation Index, and Web of Science using the following keywords Knowledge OR Awareness AND Diabetes Mellitus AND Saudi Arabia. Records were screened, and relevant studies were selected and synthesized narratively.nnResultsnNineteen articles are included in our systematic review. These studies included the following populations DM patients (n13), healthcare workers (n3), medical students (n1), secondary school students (n1), and general population (n1). Most studies found a lack of public awareness of the risk factors and complications of DM. Among medical students and healthcare workers, knowledge about the epidemiology of the disease and angle of insulin injection was deficient.nnConclusionnThis review highlights the need for increased knowledge and awareness of DM among the Saudi population. The means of improving knowledge and awareness of DM needs to be integrated into existing healthcare systems and processes to better inform patients, families, and communities about this chronic disease., PROSPERO REG. NO CRD 42018098787,DOI10.15537/smj.2018.10.22938,ISSN0379-5284,notePMID 30284579nPMCID PMC6201026,journalAbbreviationSaudi Med J,authorfamilyAlanazi,givenFaisal K.,familyAlotaibi,givenJazi S.,familyPaliadelis,givenPenny,familyAlqarawi,givenNada,familyAlsharari,givenAbdalkarem,familyAlbagawi,givenBander,issueddate-parts2018,10,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Alanazi et al., 2018)
Another research study which resonated the analysis, was also extracted using Google Scholar. The study was found using key words cohort study on diabetes. This research discusses and provides acumen to the awareness treatment and control of the DM among middle-aged and elderly people in a rural Chinese population. The article named as Prevelence, awareness, treatment and control of diabetes mellitus among middle-aged and elderly people in a rural Chinese Populatio A cross-sectional study. This research is actually a cross-sectional study on the subject matter. ADDIN ZOTERO_ITEM CSL_CITATION citationIDJzBXUZ9z,propertiesformattedCitation(Wang et al., 2018),plainCitation(Wang et al., 2018),noteIndex0,citationItemsid168,urishttp//zotero.org/users/local/jsvqEXt1/items/LRHWJZBR,urihttp//zotero.org/users/local/jsvqEXt1/items/LRHWJZBR,itemDataid168,typearticle-journal,titlePrevalence, awareness, treatment and control of diabetes mellitus among middle-aged and elderly people in a rural Chinese population A cross-sectional study,container-titlePLOS ONE,pagee0198343,volume13,issue6,sourceDOI.org (Crossref),DOI10.1371/journal.pone.0198343,ISSN1932-6203,title-shortPrevalence, awareness, treatment and control of diabetes mellitus among middle-aged and elderly people in a rural Chinese population,journalAbbreviationPLoS ONE,languageen,authorfamilyWang,givenQian,familyZhang,givenXu,familyFang,givenLi,familyGuan,givenQingbo,familyGuan,givenLiying,familyLi,givenQiu,editorfamilyHu,givenCheng,issueddate-parts2018,6,1,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Wang et al., 2018)
Another article which is an RCT study of diabetes and focuses on the European region stresses upon the importance of weight loss maintenance and risk prediction of Type 2 DM. This study was also taken from Google Scholar using key-words RCT study on diabetes. The article is named as Importance of weight loss maintenance and risk prediction in the prevention of Type 2 Diabetes Analysis of European Diabetes Prevention study RCT. The study mainly focuses on the need of rational life-style intervention to prevent T2DM (Type 2 Diabetes Mellitus) ADDIN ZOTERO_ITEM CSL_CITATION citationIDdVDV3P4Z,propertiesformattedCitation(Penn et al., 2013),plainCitation(Penn et al., 2013),noteIndex0,citationItemsid166,urishttp//zotero.org/users/local/jsvqEXt1/items/6368D9J2,urihttp//zotero.org/users/local/jsvqEXt1/items/6368D9J2,itemDataid166,typearticle-journal,titleImportance of Weight Loss Maintenance and Risk Prediction in the Prevention of Type 2 Diabetes Analysis of European Diabetes Prevention Study RCT,container-titlePLoS ONE,pagee57143,volume8,issue2,sourceDOI.org (Crossref),abstractBackground Prevalence of type 2 diabetes (T2D) is increasing worldwide. T2D prevention by lifestyle intervention is effective. Pragmatic scalable interventions are needed, with evidence to efficiently target and monitor such interventions. We report pooled analyses of data from three European trial cohorts to analyse T2D incidence, sustained weight loss and utility of risk predictors.nMethods We analysed data on 749 adults with impaired glucose tolerance (278 men and 471 women, mean age 56 years, mean BMI 31 kgm22) recruited between 1993 and 2003, and randomised to intensive lifestyle intervention (I) or lifestyle advice control (C). The intervention aimed to increase physical activity, modify diet, and promote weight loss5. Using Cox-regression survival analysis, we assessed T2D incidence and the impact on T2D incidence of sustained weight loss, and of baseline cut-point values of FINDRISC score, fasting plasma glucose (FPG), and HbA1c.nResults Mean follow-up duration was 3.1 years. T2D was diagnosed in 139 participants (I 45/379, C 94/370). Cumulative T2D incidence was 57 lower in the intervention compared with the control group (HR 0.42 (95 CI 0.29 to 0.60) P,0.001). Participants with 5 weight loss at one year had 65 lower T2D incidence (HR 0.35 (95 CI 0.22 to 0.56) P,0.001) maintaining 5 weight loss for two and three years further reduced T2D incidence. Recommended cut-points to identify those at high risk for T2D would have identified different proportions of European Diabetes Prevention Study (EDIPS) participants with similar hazard-ratios for intervention effect.nConclusions Pooled analysis of EDIPS trial data reinforces evidence for T2D prevention by lifestyle intervention. Analysis showed the preventive effect of 5 weight loss, especially if maintained long term, which has utility for intervention monitoring. Analysis of proposed cut-points demonstrates difficulties in balancing risk and benefit, to efficiently target interventions and suggests evidence is needed to define clinical policy.,DOI10.1371/journal.pone.0057143,ISSN1932-6203,title-shortImportance of Weight Loss Maintenance and Risk Prediction in the Prevention of Type 2 Diabetes,journalAbbreviationPLoS ONE,languageen,authorfamilyPenn,givenLinda,familyWhite,givenMartin,familyLindstrm,givenJaana,familyBoer,givenAnnemieke Th.,non-dropping-particleden,familyBlaak,givenEllen,familyEriksson,givenJohan G.,familyFeskens,givenEdith,familyIlanne-Parikka,givenPirjo,familyKeinnen-Kiukaanniemi,givenSirkka M.,familyWalker,givenMark,familyMathers,givenJohn C.,familyUusitupa,givenMatti,familyTuomilehto,givenJaakko,editorfamilyCasarini,givenDulce Elena,issueddate-parts2013,2,25,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Penn et al., 2013).
The researches were selected on the basis of their study design coupled with the detailed statistical analysis on the subject matter. All three research articles selected if commingled would help to generate a detailed analysis and would highlight the shortcomings, if any.
Results
Research Article 1.
Q. NoQuestion AnswerJustification1.Were the criteria for inclusion in the sample clearly definedYesThe participants inclusion criteria in the was closed and strict. Clearly outlined the participants of the study.2.Were the study subjects and the setting described in detailYesThe research article described who they recruited for the study, why they recruited and what method did they rely on for the tests.3.Was the exposure measured in a valid and reliable wayYesExposure was measure in a valid way through properly designs questionnaire.4.Were objective, standard criteria used for measurement of the conditionYesYes Measurements were relied upon the clear objective presented by the research.5.Were confounding factors identifiedUnclearThe research article did not discuss confounding factors such as hypertension explicitly.6.Were strategies to deal with confounding factors statedNoConfounding were not discussed explicitly and no strategy was outlined to deal with confounding factors. 7.Were the outcomes measured in a valid and reliable wayYesThe research used suitable questionnaires to measure the outcomes and questionnaires were also according to the objective of the research.8.Was appropriate statistical analysis usedYesLegitimate statistical analysis coupled with suitable tools according to the condition were used in the research.
Research Article 2
Q. NoQuestion AnswerJustification1.Were the criteria for inclusion in the sample clearly definedYesThe participants inclusion criteria in the was closed and strict. Clearly outlined the participants of the study.2.Were the study subjects and the setting described in detailYesThe research article described who they recruited for the study, why they recruited and what method did they rely on for the tests.3.Was the exposure measured in a valid and reliable wayYesExposure was measure in a valid way through properly designs questionnaire couple with face to face interviews.4.Were objective, standard criteria used for measurement of the conditionYesYes Measurements were relied upon the clear objective presented by the research.5.Were confounding factors identifiedNoThe research article did not discuss confounding factors such as hypertension explicitly.6.Were strategies to deal with confounding factors statedNoConfounding were not discussed explicitly and no strategy was outlined to deal with confounding factors. 7.Were the outcomes measured in a valid and reliable wayYesThe research used suitable questionnaires to measure the outcomes and questionnaires were also according to the objective of the research.8.Was appropriate statistical analysis usedYesLegitimate statistical analysis coupled with suitable tools according to the condition were used in the research.
Research Article 3.
Q. NoQuestion AnswerJustification1.Were the criteria for inclusion in the sample clearly definedYesThe participants inclusion criteria in the was closed and strict. Clearly outlined the participants of the study.2.Were the study subjects and the setting described in detailYesThe research article described who they recruited for the study, why they recruited and what method did they rely on for the tests.3.Was the exposure measured in a valid and reliable wayYesExposure was measure in a valid way through properly designs questionnaire couple with face to face interviews.4.Were objective, standard criteria used for measurement of the conditionYesYes Measurements were relied upon the clear objective presented by the research.5.Were confounding factors identifiedNoThe research article did not discuss confounding factors such as hypertension explicitly.6.Were strategies to deal with confounding factors statedNoConfounding were not discussed explicitly and no strategy was outlined to deal with confounding factors. 7.Were the outcomes measured in a valid and reliable wayYesThe research used suitable questionnaires to measure the outcomes and questionnaires were also according to the objective of the research.8.Was appropriate statistical analysis usedYesLegitimate statistical analysis coupled with suitable tools according to the condition were used in the research. SPSS and EDIPS was used and quantitative analysis were carried out by chi-square.
Discussion
Research Article 1
The first article, which is a case-control study of risk factors for the development of Type 2 DM, asserts that the physical activity is a protective measure concomitant to the reduce peril of Type 2 DM. The assertion laid down by the first research is for middle aged men and women. The results from the first research are biased towards the middle-aged men and women. Further the results of the first research did not take account of the confounding factors especially hypertensions and the whole research was stressing upon the importance of the physical activity. The sample inclusion criteria were clearly outlined by the 1st research coupled with detailed description of study subjects and settings. explicitly included those who had previously diagnosed as hyperlipidemia and were taken anti-cholesterol drugs. In addition, a control group was also identified, the control group did not meet the above criteria and was declared free of the type 1 diabetes. Samples meeting above criteria were randomly selected and co control group criteria were also selected by frequency matching. ADDIN ZOTERO_ITEM CSL_CITATION citationIDi8jDG2aw,propertiesformattedCitation(Andersen et al., 1983),plainCitation(Andersen et al., 1983),noteIndex0,citationItemsid179,urishttp//zotero.org/users/local/jsvqEXt1/items/5NTGIL6R,urihttp//zotero.org/users/local/jsvqEXt1/items/5NTGIL6R,itemDataid179,typearticle-journal,titleDiabetic nephropathy in type 1 (insulin-dependent) diabetes An epidemiological study,container-titleDiabetologia,volume25,issue6,sourceDOI.org (Crossref),abstractSummary. A follow-up of 1475 Type 1 (insulin-dependent) diabetic patients diagnosed before 1953 (815males, 660females) and before the age of 31 years was conducted. All patients Were seen at the Steno Memorial Hospital and were referred from all parts of Denmark 91 (6) could not be traced. The rest (94) were followed until death or for at least 25 years 249 (17) were followed for 40years. Clinical diabetic nephropathy developed in 531 (41) of the 1303 patients in whom sufficient information was available regarding proteinuria. Other causes of proteinuria were found in 3, and 57 did not develop persistent proteinuria. The prevalence of diabetic nephropathy was 21 after 20-25 years of diabetes duration followed by a decline to 10 after 40 years. Two incidence peaks of the onset of proteinuria were seen, one after 16 and another after 32 years duration of diabetes. Incidence increased steeply 10 years after onset of diabetes and was low after 35 years duration. The cumulative incidence was 45 after 40 years of diabetes. A male preponderance was seen among patients with nephropathy. A significant difference in the pattern of annual incidence rates of diabetic nephropathy was seen, when groups with onset of diabetes before 1933, between 1933-1942, and 1943-1952, respectively, were compared. An association between daily insulin requirement and nephropathy incidence was found. Patients with nephropathy had a much poorer survival than those without proteinuria 40 years after onset of diabetes, only 10 of patients who developed nephropathy were alive, whereas 70 of patients who did not develop nephropathy survived. Uraemia was the cause of death in 66 of the patients with nephropathy 7 years after the onset of persistent proteinuria, 49 of the patients had died. It is concluded that diabetic nephropathy is the major life threatening complication in Type I diabetes of juvenile onset.,URLhttp//link.springer.com/10.1007/BF00284458,DOI10.1007/BF00284458,ISSN0012-186X, 1432-0428,title-shortDiabetic nephropathy in type 1 (insulin-dependent) diabetes,journalAbbreviationDiabetologia,languageen,authorfamilyAndersen,givenA.R.,familyChristiansen,givenJ.Sandahl,familyAndersen,givenJ.K.,familyKreiner,givenS.,familyDeckert,givenT.,issueddate-parts1983,12,accesseddate-parts2019,5,4,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Andersen et al., 1983)
So far as the exposure measurement is concerned then it was also measured in a reliable way with the help of questionnaire which was self-administered. The measuring tool was categorized into two parts pertaining to the life-style and habits of the participants. Biographical questionnaire was also prepared to fetch data from participants concerning their residence, age, sex, marital status etc. Measurement of the condition was also according to the standard criteria and it was done with the help of Baeckes index. ADDIN ZOTERO_ITEM CSL_CITATION citationIDvI7HWiBb,propertiesformattedCitation(Muninarayana, Balachandra, Hiremath, Iyengar, Anil, 2010),plainCitation(Muninarayana, Balachandra, Hiremath, Iyengar, Anil, 2010),noteIndex0,citationItemsid173,urishttp//zotero.org/users/local/jsvqEXt1/items/T333F78K,urihttp//zotero.org/users/local/jsvqEXt1/items/T333F78K,itemDataid173,typearticle-journal,titlePrevalence and awareness regarding diabetes mellitus in rural Tamaka, Kolar,container-titleInternational Journal of Diabetes in Developing Countries,page18-21,volume30,issue1,sourcePubMed Central,abstractBackgroundnThe worldwide prevalence of diabetes mellitus has risen dramatically in the developing countries over the past two decades. Regular screening of adults is essential for early detection and care. There are limited studies on diabetes awareness and prevalence in rural communities. Hence this prevalence and knowledge assessment study was undertaken. Such data are extremely important to plan the public health policies with specific reference to implementation of National Diabetic Control Program.nnAimsnTo study the prevalence and awareness of diabetes mellitus in rural areas.nnSettings and DesignnCross-sectional, household study.nnMaterials and MethodsnA study on adults and elderly age group in Tamaka village was undertaken. Structured questionnaire was used to assess the knowledge of diabetes and capillary blood screening tests done to detect diabetes.nnStatistical Analysis UsednSPSS - 11 software.nnResults and ConclusionsnTen per cent of the 311 adults screened had hyperglycemia. Half of the interviewed population had some awareness about diabetes and its symptoms. But more than half (75) of them were not aware of the long term effects of diabetes and diabetic care. The common perception about diet in diabetes was to avoid sweets, rice and fruits and to consume more ragi, millet and wheat chapattis. Diabetes in young adults is common. Relevant knowledge about diabetes is poor in rural population. Hence community level awareness programs have to be organized. Healthcare providers must be aware of community perceptions and practices.,DOI10.4103/0973-3930.60005,ISSN0973-3930,notePMID 20431801nPMCID PMC2859279,journalAbbreviationInt J Diabetes Dev Ctries,authorfamilyMuninarayana,givenC.,familyBalachandra,givenG.,familyHiremath,givenS. G.,familyIyengar,givenKrishna,familyAnil,givenN. S.,issueddate-parts2010,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Muninarayana, Balachandra, Hiremath, Iyengar, Anil, 2010) The levels were defined in a subtle way i.e. low level, middle level and high level. Participants were then segregated on the basis of the level of their physical activity.
The only shortcoming analyzed in the serious which should not have been there is the identification of confounding factors. Albeit confounding was discussed but not explicitly. Neither was there any strategy to deal with confounding factors. For they were not identified. Had they been identified the research might have discussed strategies to deal with the confounding factors. From the very outset of the research it can be concluded that outcomes were measured in a valid manner with the help of tables generated following the data analysis provided by participants. Whole data was analysis using legitimate statistical tools and operations such as SPSS which is legitimate tool for carrying out cross-sectional study.
Overall the research is good but there are some limitations of the research. These are Only adulthood period was considered concerning physical activity, the participants or the subjects of the study were diagnosed with type 2 diabetes and dyslipidemia, so this would make the study biased, and the whole population were civilians so its quite difficult to generalize the results to other participants.
Research Article 2
The second research which primarily discusses the prevalence, awareness and control of the diabetes of elderly people in China has some strengths and limitations as well. In the discussion following, the anatomy of all the questions will be discussed. The inclusion criteria of the participants in the study was clearly delineated and explicitly discusses only those propel who are who were 40 or above. The study excluded those people who did not provide vital data such as age, sex, location, marital status. Exposure was measured in an excellent manner by this research through well-established questionnaire and face-to-face interviews. Interviews collected data from post medical history and life-style of the occupants. Measurement of condition was carried out with standard criteria. ADDIN ZOTERO_ITEM CSL_CITATION citationIDLMMOmsBX,propertiesformattedCitation(Wang et al., 2018),plainCitation(Wang et al., 2018),noteIndex0,citationItemsid168,urishttp//zotero.org/users/local/jsvqEXt1/items/LRHWJZBR,urihttp//zotero.org/users/local/jsvqEXt1/items/LRHWJZBR,itemDataid168,typearticle-journal,titlePrevalence, awareness, treatment and control of diabetes mellitus among middle-aged and elderly people in a rural Chinese population A cross-sectional study,container-titlePLOS ONE,pagee0198343,volume13,issue6,sourceDOI.org (Crossref),DOI10.1371/journal.pone.0198343,ISSN1932-6203,title-shortPrevalence, awareness, treatment and control of diabetes mellitus among middle-aged and elderly people in a rural Chinese population,journalAbbreviationPLoS ONE,languageen,authorfamilyWang,givenQian,familyZhang,givenXu,familyFang,givenLi,familyGuan,givenQingbo,familyGuan,givenLiying,familyLi,givenQiu,editorfamilyHu,givenCheng,issueddate-parts2018,6,1,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Wang et al., 2018) Standard equipment was used for the measure of data like WC and BMI. Three readings were taken for each sample and the average of each sample was further recognized.
Confounding factors are not identified in the research which is a major shortcoming in the research. In the previous article confounding factors were discussed but vaguely but in this research confounding factors were explicitly ignored. There is no identification of the confounding factor and research does not delineate the strategies to delineate the strategies to deal with confounding factors. This is a major shortcoming in the research as it halts future research based on this data for further exploration and prevention of the disease.
Measurement of the outcomes was carried out in a reliable manner with the help of reliable statistical analysis. Measuring outcomes were also categorized carefully organized in the form of tables. The research clearly segregated the all the tables according to the measuring outcomes and data which provide a clear insight into the results. Statistical analysis was carried out in a perfect manner using suitable statistical tool and formula for the statistical analysis of the data using multiple regression. The use of multiple regression technique actually makes the result and calculation of the data more legitimate.
The strength of the research is that it was carried out by a large representation of rural population and used all the indicators for the diagnosis and evaluation of the DM. As far as the limitations are concerned, the research includes both type 1 and type 2 patients which at certain might affect the study or make it vague. The profoundness of the study can be compromised by this. Moreover, the method for taking blood sample i.e. venous blood is not legitimate and can affect the results of the study. The research overall concludes that DM is increasing by leaps and bounds in the rural parts of the China.
Research Article 3
The third research article is another piece which make the subject matter of this critical analysis. The questions provided in the checklist are profoundly discussed in the third article. So far as 1st two questions of the research are concerned then undoubtedly, research explicitly define the participants inclusion criteria coupled and subjects are described in detailed in the research. Participants of the research selected were over 40 years of age having BMI greater than or equal to 25kgm-2. Randomization of the population in 11 to an intensive life-style intervention is another factor which resonates the legitimacy of the research. ADDIN ZOTERO_ITEM CSL_CITATION citationIDndEambQ2,propertiesformattedCitation(Penn et al., 2013),plainCitation(Penn et al., 2013),noteIndex0,citationItemsid166,urishttp//zotero.org/users/local/jsvqEXt1/items/6368D9J2,urihttp//zotero.org/users/local/jsvqEXt1/items/6368D9J2,itemDataid166,typearticle-journal,titleImportance of Weight Loss Maintenance and Risk Prediction in the Prevention of Type 2 Diabetes Analysis of European Diabetes Prevention Study RCT,container-titlePLoS ONE,pagee57143,volume8,issue2,sourceDOI.org (Crossref),abstractBackground Prevalence of type 2 diabetes (T2D) is increasing worldwide. T2D prevention by lifestyle intervention is effective. Pragmatic scalable interventions are needed, with evidence to efficiently target and monitor such interventions. We report pooled analyses of data from three European trial cohorts to analyse T2D incidence, sustained weight loss and utility of risk predictors.nMethods We analysed data on 749 adults with impaired glucose tolerance (278 men and 471 women, mean age 56 years, mean BMI 31 kgm22) recruited between 1993 and 2003, and randomised to intensive lifestyle intervention (I) or lifestyle advice control (C). The intervention aimed to increase physical activity, modify diet, and promote weight loss5. Using Cox-regression survival analysis, we assessed T2D incidence and the impact on T2D incidence of sustained weight loss, and of baseline cut-point values of FINDRISC score, fasting plasma glucose (FPG), and HbA1c.nResults Mean follow-up duration was 3.1 years. T2D was diagnosed in 139 participants (I 45/379, C 94/370). Cumulative T2D incidence was 57 lower in the intervention compared with the control group (HR 0.42 (95 CI 0.29 to 0.60) P,0.001). Participants with 5 weight loss at one year had 65 lower T2D incidence (HR 0.35 (95 CI 0.22 to 0.56) P,0.001) maintaining 5 weight loss for two and three years further reduced T2D incidence. Recommended cut-points to identify those at high risk for T2D would have identified different proportions of European Diabetes Prevention Study (EDIPS) participants with similar hazard-ratios for intervention effect.nConclusions Pooled analysis of EDIPS trial data reinforces evidence for T2D prevention by lifestyle intervention. Analysis showed the preventive effect of 5 weight loss, especially if maintained long term, which has utility for intervention monitoring. Analysis of proposed cut-points demonstrates difficulties in balancing risk and benefit, to efficiently target interventions and suggests evidence is needed to define clinical policy.,DOI10.1371/journal.pone.0057143,ISSN1932-6203,title-shortImportance of Weight Loss Maintenance and Risk Prediction in the Prevention of Type 2 Diabetes,journalAbbreviationPLoS ONE,languageen,authorfamilyPenn,givenLinda,familyWhite,givenMartin,familyLindstrm,givenJaana,familyBoer,givenAnnemieke Th.,non-dropping-particleden,familyBlaak,givenEllen,familyEriksson,givenJohan G.,familyFeskens,givenEdith,familyIlanne-Parikka,givenPirjo,familyKeinnen-Kiukaanniemi,givenSirkka M.,familyWalker,givenMark,familyMathers,givenJohn C.,familyUusitupa,givenMatti,familyTuomilehto,givenJaakko,editorfamilyCasarini,givenDulce Elena,issueddate-parts2013,2,25,schemahttps//github.com/citation-style-language/schema/raw/master/csl-citation.json (Penn et al., 2013) Intensive life-style intervention which participants were subjected to encourage increased physical activity. Staff delivering the intervention and participants, none of the either were masked to study arm.
The exposure was measured in a valid and reliable way that control group participants were given information about healthy diets and physical activity. Sessions regarding physical activity and admittance to leisure amenities was also promoted. Standard criteria and objective and were used to for the measurement of the condition. As participants received an assessment of clinical nature which included OGTT and blood biochemistry measurements on the annual basis.
So far as the confounding factors are concerned so they were neglected altogether in the study. There is no identification of the confounding factors in the study as the study strictly based upon the importance of weight loss maintenance and risk prediction in the type 2 diabetes. No identification of the confounding factors which means no strategies to deal with the confounding factors. The outcomes were measured in a clear manner by the research. Determination of T2D was carried out on the annual basis with the help of OGTT. Further legitimate statistical analysis was carried out using pooled EDIPS data set and SPSS. Independent t-test and chi square was used to carry the interdependence of the variables. Graphs and tables generated by the analysis depicts results in a clear manner. The research reinforces that life-style intervention can play a significant role in the prevention of the T2D in with adults and also witnesses the generalizability of T2D in Europeans.
Conclusions
The essay delineates all the shortcomings and positive aspects of the three researches carried out to for the awareness and prevention of diabetes. The basic purpose of the essay was to examine the research question critically and draw a final conclusion on the three pieces of research. The essay, undoubtedly provides a clear insight to all the researches considered and gives readers an outlook that what to search for in these researches. The analysis also delineates that what have been discussed and what has been not on the basis of set criteria set by the checklist. The researchers are biased in one way or other but all the three studies provide a great opportunity for the future researchers to address the ambiguities not addressed in these researches. The appraisal actually gives an insight to the cross-sectional design of the subject matter which is the awareness about the disease and delineates the way the preventive measures possible for the research. It would help the readers to have a bird eye view regarding the researches and build their opinion concerning the works analyzed in the essay.
References
ADDIN ZOTERO_BIBL uncited,omitted,custom CSL_BIBLIOGRAPHY Alanazi, F. K., Alotaibi, J. S., Paliadelis, P., Alqarawi, N., Alsharari, A., Albagawi, B. (2018). Knowledge and awareness of diabetes mellitus and its risk factors in Saudi Arabia. Saudi Medical Journal, 39(10), 981989. https//doi.org/10.15537/smj.2018.10.22938
Andersen, A. R., Christiansen, J. S., Andersen, J. K., Kreiner, S., Deckert, T. (1983). Diabetic nephropathy in type 1 (insulin-dependent) diabetes An epidemiological study. Diabetologia, 25(6). https//doi.org/10.1007/BF00284458
Egede, L. E., Zheng, D. (2003). Independent Factors Associated With Major Depressive Disorder in a National Sample of Individuals With Diabetes. Diabetes Care, 26(1), 104111. https//doi.org/10.2337/diacare.26.1.104
Muninarayana, C., Balachandra, G., Hiremath, S. G., Iyengar, K., Anil, N. S. (2010). Prevalence and awareness regarding diabetes mellitus in rural Tamaka, Kolar. International Journal of Diabetes in Developing Countries, 30(1), 1821. https//doi.org/10.4103/0973-3930.60005
Penn, L., White, M., Lindstrm, J., den Boer, A. Th., Blaak, E., Eriksson, J. G., Tuomilehto, J. (2013). Importance of Weight Loss Maintenance and Risk Prediction in the Prevention of Type 2 Diabetes Analysis of European Diabetes Prevention Study RCT. PLoS ONE, 8(2), e57143. https//doi.org/10.1371/journal.pone.0057143
Wang, Q., Zhang, X., Fang, L., Guan, Q., Guan, L., Li, Q. (2018). Prevalence, awareness, treatment and control of diabetes mellitus among middle-aged and elderly people in a rural Chinese population A cross-sectional study. PLOS ONE, 13(6), e0198343. https//doi.org/10.1371/journal.pone.0198343
Running Head EPIDEMIOLOGY PAGE MERGEFORMAT 1
EPIDEMIOLOGY PAGE MERGEFORMAT 9
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