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Objective: To study the clinical characteristics related to metabolic disorders and complications in type 2 diabetes mellitus patients hospitalized in the Qingdao Endocrine and Diabetes Hospital from 2006 to 2012 in Qingdao, China. Patient population and methods: Data from 14,289 (51% males) type 2 diabetes mellitus patients hospitalized between 2006 and 2012 were collected and analysed. Information on patients’ demographic, anthropometric, laboratory and disease histories were extracted from electronic medical records. Results: The mean age of the patients was 60.5 years, with median diabetes duration of 9.0 years. Mean haemoglobin A1c was 8.4%, where <30.0% of patients had haemoglobin A1c <7.0%. In all, 34.5% of patients had low-density lipoprotein cholesterol lower than 2.6 mmol/L and 31.9% had hypertriglyceridaemia. Retinopathy was diagnosed in 51.1% of patients, nephropathy in 21.6%, neuropathy in 50.4%, hypertension in 77.4%, coronary heart disease in 27.6% and peripheral vascular disease in 58.6%. Once hospitalized, 71.1% of patients underwent insulin injection treatments, either mono-therapy or combined with other anti-diabetic drugs. Metformin was prescribed to 36.9% of patients, followed by acarbose 29.9%, thiazolidinediones 18.1%, meglitinides 14.8% and sulfonylureas 10.7%. Conclusion: Inadequate control of hyperglycaemia, poor metabolic profiles and diabetic complications were common challenges for long-term diabetes management in Chinese patients with type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Background A simplified model not requiring a clinic visit is important for cardiovascular prevention. We compared such a model, with one requiring clinical measurements for prediction of ischemic stroke. Methods Five population-based Finnish cohorts comprising 14 296 men and 16 065 women aged 25-64 years were randomly recruited from 1982, and followed up using the national registers until the end of the 2007. The final Cox model included age, prior history of diabetes and hypertension, happy marriage, capability to walk 500 m (self-estimate), regular exercise, vegetable/fruit intake, smoking, body mass index, and systolic blood pressure; the layperson-oriented model was developed by taking blood pressure away from the final model. Results Four hundred sixty-nine men and 371 women developed ischemic stroke events. The area under the receiver operating characteristic curve (95% confidence interval) for 10 years incidence of ischemic stroke was 0·817 (0·791-0·843) and 0·813 (0·787-0·839) for the model with and without systolic blood pressure in men and 0·815 (0·782-0·848) and 0·812 (0·779-0·844), respectively, in women ( P > 0·10). The predicted 10-year events rate matched well with the observed one across deciles of the predicted risk in men (χ2 = 11·57, 9df, P = 0·239) and in women (χ2 = 11·18, P = 0·263). The overall net reclassification improvement after adding blood pressure was 8·8% ( P = 0·016) in men and 3·2% ( P = 0·234) in women. The predicted 10-year risk of the ischemic stroke based on global vascular event models that includes coronary heart diseases did not match well with the observed stroke risk. Conclusions The layperson model performed as well as the clinical-based one. [ABSTRACT FROM AUTHOR]

The clustering of metabolic and pathophysiological cardiovascular risk factors has long been recognized but it was Reaven who popularized the syndrome in the Banting lecture of 1988. Since 1999, several major international or national organizations proposed their own definitions for the syndrome, named the metabolic syndrome. The prevalence of the metabolic syndrome varies according to definition, ethnicity and gender. The prevalence is under 20% among Chinese and Korean people but over 50% among Maori and Pacific Islanders in New Zealand. People with the metabolic syndrome have 50–60% higher cardiovascular risk than those without. The absolute cardiovascular risk of the metabolic syndrome, however, is not necessarily higher than those of its individual components. The pathogenesis underlying the clustering of cardiovascular risk factors remains unclear. Factors including genetic disposition, obesity, insulin resistance and inflammation have been suggested as being involved. Since the metabolic syndrome is multifactorial in origin, strategies for reducing cardiovascular risk in individuals with the metabolic syndrome involve the management of multiple risks. Lifestyle changes are an effective first-line management; pharmacological interventions for hypertension, diabetes and dyslipidaemia are in accordance with established guidelines. Pharmacological and surgical therapies for obesity are effective in selected patients. In this article we discuss the definitions, prevalence, pathogenesis and management of the metabolic syndrome in relation to cardiovascular risk. [ABSTRACT FROM AUTHOR]