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Biomedical subjects

E Eschwege

Publications and source records attributed to E Eschwege.

At least 55 records · Page 3Linked to original sources
PubMed1991

The prevalence of diabetes mellitus in the adult population of Guadeloupe as estimated by history or fasting hyperglycemia.

A study was conducted between January 1984 and March 1985 to determine the prevalence of diabetes in the adult population of Guadeloupe (18 years of age and over). A two-step sampling frame, using a sampling fraction of 0.46%, where the primary units were composed of districts and where sub-units were households, was used. The household refusal rate was 22%. Subjects were classified as 'diabetic' when they were either already known or when their fasting plasma glucose was above 8.0 mmol/l. The total age and sex standardized prevalence of diabetes among the adult population of Guadeloupe can be estimated at 6.6%. The high prevalence rate appears to be related to obesity (strongly in women), a genetic susceptibility (22.5% of age standardized prevalence among subjects of Asian Indian origin for both sexes), and, possibly, in men of African origin only, to a maternal history of diabetes.

Adult↗
PubMed1991

Risk factors for NIDDM in white population. Paris prospective study.

Risk factors for non-insulin-dependent diabetes mellitus (NIDDM) were assessed in a population of 5042 middle-aged white men, initially nondiabetic, who were followed 3 yr. The subjects were participants in the Paris Prospective Study I. Sixty-three subjects developed diabetes during the follow-up. Plasma glucose concentration in the years before the occurrence of the disease was a major risk factor. Subjects with normal glucose tolerance but elevated fasting plasma glucose exhibited a similar risk of developing NIDDM as did subjects classified as having impaired glucose tolerance on the basis of 2-h postload glucose. In a multiple logistic regression, a high fasting plasma insulin concentration and a low 2-h plasma insulin concentration after a glucose load in association with a high body mass index were independent predictors of conversion to NIDDM from impaired glucose tolerance. Previously, this result had been found only in Nauruans, Pima Indians, and Japanese. This demonstrates for the first time in a white population that a high fasting and low 2-h insulin concentration is predictive of conversion to NIDDM from impaired glucose tolerance.

Aged↗
PubMed1990

Factors influencing birth weight in newborns of diabetic and non-diabetic women. A population based study.

Maternal diabetes is known to be related to an increase in birth weight of the offspring. However, the mechanism of the association is not entirely clear. In addition, the contribution of the demographic, obstetric and metabolic factors to birth weight in diabetic mothers is not well defined. All the diabetic women (68 requiring insulin-treatment and 403 on diet alone) and a random sample of 1 in 12 of all non-diabetic women (893 women) who delivered in one regional hospital between March 1987 and June 1988 inclusive, were included in the study. Tests for gestational diabetes are routinely performed in our pregnant women population, thus, the study is a population based one. The mean birth weight of infants of diabetic mothers adjusted for gestational age was higher than in those of non-diabetic mothers. However, no relationship was found between maternal glycosylated hemoglobin measured at delivery and the infants birth weight. Furthermore, at each week of gestation, infants born to diabetic mothers were heavier than the infants of non-diabetic mothers (for weeks 37 to 40, p less than 0.05), while no differences were found in glycosylated hemoglobin levels between the two groups at any time. In a multivariate model we showed that after controlling for gestational age, the only factors which independently and significantly affected birth weight in our population were diabetes, ethnic origin, and the parity of the mother. Our findings support the possibility that substances which induce hyperinsulinemia, other than glucose, may be related to the higher birth weight of infants of diabetic mothers.

Adult↗
PubMed1990

Comparison of HbA1 and fructosamine in diagnosis of glucose-tolerance abnormalities.

Total glycosylated hemoglobin (HbA1) and fructosamine were evaluated as screening tools for detection of glucose-tolerance abnormalities in 144 asymptomatic subjects undergoing a 75-g oral glucose tolerance test. Subjects were classified according to World Health Organization criteria as having normal (n = 78), impaired (n = 40), or diabetic (n = 26) glucose tolerance. We found good specificity for HbA1 and fructosamine (100 and 97%, respectively) but low sensitivity (15 and 19%, respectively). At the intersection of the curves of sensitivity and specificity drawn from various thresholds of normality, both sensitivity and specificity were 75% for HbA1 and 55% for fructosamine. Thus, neither HbA1 nor fructosamine seems to be suitable for the diagnosis of mild abnormalities in glucose tolerance.

Blood Glucose↗
PubMed1990

Comparison of fructosamine with glycated hemoglobin as an index of glycemic control in diabetic patients.

Fasting and postprandial (or post-glucose load) plasma glucose, total HbA1 and fructosamine (F) were simultaneously assessed in 371 diabetic patients (125 insulin dependent and 246 non-insulin dependent) and in 122 nondiabetic subjects, (98 with normal glucose tolerance and 24 with impaired glucose tolerance). Fructosamine yielded nearly similar information as HbA1 about glycemic control, since similar relationships were observed between plasma glucose values and HbA1 or fructosamine levels in the different groups. A longitudinal study performed during a three-month follow-up in 74 diabetic patients and extended to six months in 19 of them, without any modification of treatment, indicated that reproducibility of HbA1 and fructosamine was nearly the same with a slight advantage for HbA1. The only clinically significant difference results from the longer half-life of hemoglobin when compared to serum proteins. Fructosamine assay should be proposed as a complement of HbA1 in the management of diabetic patients when detection of recent metabolic changes is needed.

Adult↗
PubMed1989

Alcohol consumption in Guadeloupe.

This study bears upon the patterns of alcohol consumption in Guadeloupe (French West Indies), and has been carried out over a representative sample of adults. Each subject was questioned about his or her consumption of alcoholic drinks and a blood sample taken to measure the biological indicators of chronic alcohol consumption. The resulting mean consumption has permitted Guadeloupeans to be classed among the world's foremost consumers of alcohol. For almost half of the adult population, this consumption takes place on a daily basis and therefore constitutes part of everyday life. The patterns of alcohol consumption are linked to sex, age, level of education, employment and socio-professional categories. The heavy-drinking man tends to be elderly, has a low level of education and is an agricultural worker; his consumption is based on rum. The woman is middle-aged and not working; her consumption is based on wine. These stated characteristics permit the setting up of tailored prevention programs.

Accidents, Traffic↗
PubMed1988

The cost of diabetes in France.

Within an economic framework it is possible to evaluate the direct cost of diabetes. In 1984, for 109 diabetics - 27 insulin-dependent patients (IDD) and 82 non-insulin-dependent patients (NIDD) - of the Paris area, the average cost of diabetes was 7711 francs (Fr) for the IDD and 5892 Fr for the NIDD. This cost is the sum of the medical visits, drugs and hospitalization. The medical expenditures of the NIDD is roughly the same as for the general population (6462 Fr). For the IDD, the main difference concerns the drug expenditures. Moreover, in 1984, there is more home-care than in 1978. Lastly, there is little difference between prescription use in the U.S. and in France. Such results allow us to discuss the reimbursement of the care needed for diabetics.

Costs and Cost Analysis↗
PubMed1988

Diabetes mellitus in Tunisia: description in urban and rural populations.

A prevalence survey of diabetes mellitus was carried out in Tunisia on two random samples of households. The first sample (3826 adult subjects) was drawn from the Gouvernorat of Tunis, the second one (1787 adult subjects), was drawn from a rural area, the Gouvernorat of Siliana. The families were investigated at home and diabetes assessed on the basis of an interview (to determine known cases) and of fasting blood glucose level in subjects having no personal history of diabetes (new cases). Prevalence rates were estimated considering known cases and newly found ones together. Overall, the age-standardized prevalence rate was found to be much higher in the urban sample compared to the rural one, especially for women (4.6% versus 2.3% in men, 3.5% versus 0.6% in women). Diabetes was often associated with obesity, especially in men. Within the urban sample, the prevalence rate was similar in subjects born in Tunis and in those born in the rest of the country, thus mainly of rural extraction. In contrast, a family history of diabetes was more often reported in the former group. The results are consistent with other epidemiological findings, showing that a dramatic increase in diabetes morbidity parallels the rapid westernization of urban centres in developing countries.

Adult↗
PubMed1988

Coronary heart disease mortality risk: plasma insulin level is a more sensitive marker than hypertension or abnormal glucose tolerance in overweight males. The Paris Prospective Study.

The Paris Prospective Study I (7434 men) is a long-term investigation of cardiovascular diseases. A previous analysis has shown that high plasma insulin level was a more sensitive marker than glucose intolerance in the prediction of coronary heart disease (CHD). In order to ascertain the risk model for CHD in relation to high circulating plasma insulin level, we studied CHD mortality rates in groups of participants to the study with similar profiles of risk factors. The risk factors considered to cross-classify the subjects were: serum cholesterol level, blood pressure, fasting plasma insulin level (all the significant predictors of CHD mortality in the Cox regression model), plus body mass index (BMI) and 2-h post-load blood glucose level. Serum cholesterol level was linearly related to CHD mortality risk. The strength of the association of blood pressure to the risk was reduced when BMI increased. By contrast, the association of blood pressure to the risk remained linear when plasma insulin level rather than BMI was considered. Plasma insulin level was a more sensitive marker of CHD risk than glucose intolerance in the overweight group. Moreover, in this group, the relation to CHD mortality risk was stronger for plasma insulin level than for blood pressure.

Body Weight↗
PubMed1987

Diabetes, hyperglycaemia, hyperinsulinaemia and atherosclerosis: epidemiological data.

Beside arterial hypertension, hypercholesterolaemia and smoking habits, diabetes is considered as a risk factor of coronary heart disease (CHD). However, the role of impaired glucose tolerance (IGT) has not been demonstrated in the different epidemiological studies in the world which are summarized here; hyperinsulinaemia was also suspected and its independent role--investigated in only three prospective surveys--was demonstrated. The recent data of the Paris Prospective Study, where normoglycaemic, IGT and diabetic patients were analysed together, show that hyperinsulinaemia may be the first and genuine marker of the carbohydrate metabolism disturbance connected to the clinical manifestations of atherosclerosis.

Adult↗
PubMed1986

[Lack of benefit of blood glucose autosurveillance in insulin-treated diabetics routinely followed up in a department specializing in diabetology].

Home blood glucose monitoring (HBGM) may be useful to achieve better metabolic control in type I diabetes. The aim of this study was to evaluate longterm results in a large population. A questionnaire was given to 282 routinely insulin-treated diabetics regularly attending our clinic. Home blood glucose testing was performed by 64.5% of the patients. Seventy nine percent of them continued to test urines. Mean HbA1 at the time of the visit was not statistically different in patients performing home blood glucose testing only (9.3 +/- 2.1%), in patients monitoring both blood and urines (9.2 +/- 2%), or urines only (9.3 +/- 1.7%) and in patients who did not practice self-monitoring (9.5 +/- 1.8%). The influence of HBGM on metabolic control as currently performed by diabetic patients in everyday life may be overemphasized. These disappointing results are mainly due to the fact that patients carry out passive home glucose testing and not home blood glucose monitoring which implies day-to-day adaptation of insulin dosage. Such an attitude seems to be due to incorrect selection of the patients, insufficient education and care and, for some patients, poor compliance with medical advice.

Blood Glucose↗