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1. Quality assessment of patients’ self-monitoring of blood glucose in community pharmacies

Author

Kjome RL, Granas AG, Nerhus K, and Sandberg S

Subjects
Blood Glucose Self-Monitoring, Quality Assurance, Health Care, Community Pharmacy Services, Norway, Therapeutics. Pharmacology, RM1-950, Pharmacy and materia medica, RS1-441
Abstract

Objective: To evaluate diabetes patients’ self-monitoring of blood glucose using a community pharmacy-based quality assurance procedure, to investigate whether the procedure improved the quality of the patient performance of self monitoring of blood glucose, and to examine the opinions of the patients taking part in the study. Methods: The results of patient blood glucose measurements were compared to the results obtained with HemoCue Glucose 201+ by pharmacy employees in 16 Norwegian community pharmacies. Patient performance was monitored using an eight item checklist. Patients whose blood glucose measurements differed from pharmacy measurements by more than 20% were instructed in the correct use of their glucometer. The patients then re-measured their blood glucose. If the results were still outside the set limits, the control procedure was repeated with a new lot of glucometer strips, and then with a new glucometer. The patients returned for a follow-up visit after three months. Results: During the first visit, 5% of the 338 patients had measurements that deviated from pharmacy blood glucose values by more than 20% and user errors were observed for 50% of the patients. At the second visit, there was no significant change in the analytical quality of patient measurements, but the percentage of patients who made user errors had decreased to 29% (p < 0.001). Eighty-five percent of the patients reported that they used their blood glucose results to adjust medication, exercise or meals. Fifty-one percent of the patients reported a greater trust in their measurements after the second visit. Eighty percent of patients wished to have their measurements assessed yearly. Of these patients, 83% preferred to have the assessment done at the community pharmacy. Conclusion: A community pharmacy-based quality assessment procedure of patients’ self monitoring of blood glucose significantly reduced the number of user errors. The analytical quality of the patients’ measurements was good and did not improve further during the study. The high analytical quality might be explained by a selection bias of participating patients. Patients also reported increased confidence in their blood glucose measurements after their measurements had been assessed at the pharmacy.

Published
2010

2. The global cardiovascular risk transition: associations of four metabolic risk factors with national income, urbanization, and Western diet in 1980 and 2008

Author

Danaei, G., Singh, G., Paciorek, C., Lin, J., Cowan, M., Finucane, M., Farzadfar, F., Stevens, G., Riley, L., Lu, Y., Rao, M., Ezzati, M., Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group, Aamodt, G., Abdeen, Z., Abdella, N., Rahim, H., Addo, J., Aekplakorn, W., Afifi, M., Agabiti Rosei, E., Aguilar Salinas CA, Agyemang, C., Ali, M., Al Nsour, M., Al Nuaim AR, Ambady, R., Aro, P., Azizi, F., Barbagallo, C., Barbieri, M., Barceló, A., Barreto, S., Barros, H., Bautista, L., Benetos, A., Bjerregaard, P., Björkelund, C., Bo, S., Bobak, M., Bonora, E., Bontha, B., Botana, M., Bovet, P., Breckenkamp, J., Breteler, M., Broda, G., Brown, I., Bursztyn, M., Cabrera de León, A., Campos, H., Cappuccio, F., Capuano, V., Casiglia, E., Castellano, M., Castetbon, K., Cea, L., Chang, C., Chaouki, N., Chatterji, S., Chen, Z., Chen, C., Choi, J., Chua, L., Cífková, R., Cobiac, L., Cooper, R., Corsi, A., Costanza, M., Craig, C., Dankner, R., Dastgiri, S., Delgado, E., Dinc, G., Doi, Y., Dong, G., Dorsi, E., Dragano, N., Drewnowski, A., Eggertsen, W., Elliott, P., Engeland, A., Erem, C., Esteghamati, A., Fall, C., Fan, J., Ferreccio, C., Fezeu, L., Firmo, J., Florez, H., Fornés, N., Fowkes, F., Franceschini, G., Frisk, F., Fuchs, F., Fuller, E., Getz, L., Giampaoli, S., Gómez, L., Gomez Zumaquero JM, Graff Iversen, S., Grant, J., Guerrero Carvajal, R., Gulliford, M., Gupta, R., Gupta, P., Gureje, O., Hansen, T., Hata, J., He, J., Heim, N., Heinrich, J., Hemmingsson, T., Hennis, A., Herman, W., Herrera, V., Ho, S., Holdsworth, M., Hollman Frisman, G., Hopman, W., Hussain, A., Husseini, A., Ibrahim, M., Ikeda, N., Jacobsen, B., Jaddou, H., Jafar, T., Janghorbani, M., Jasienska, G., Joffres, M., Jonas, J., Kadiki, O., Kalter Leibovici, O., Kamadjeu, R., Karalis, I., Kastarinen, M., Katz, J., Keinan Boker, L., Kelly, P., Khalilzadeh, O., Khang, Y., Kiechl, S., Kim, K., Kiyohara, Y., Kobayashi, J., Krause, M., Kubínová, R., Kurjata, P., Kusuma, Y., Lam, T., Langhammer, A., Lawes, C., Le, C., Lee, J., Lévy Marchal, C., Li, Y., Lim, S., Lim, T., Lin, X., Lin, C., Lin, H., Lind, L., Lissner, L., Liu, X., Lopez Jaramillo, P., Lorbeer, R., Ma, G., Ma, S., Macià, F., Maclean, D., Maggi, S., Magliano, D., Makdisse, M., Mancia, G., Mannami, T., Marques Vidal, P., Mbanya, J., McFarlane Anderson, N., Miccoli, R., Miettola, J., Minh, H., Miquel, J., Miranda, J., Mohamed, M., Mohan, V., Mohanna, S., Mokdad, A., Mollentze, W., Morales, D., Morgan, K., Muiesan, L., Muntoni, S., Nabipour, I., Nakagami, T., Nangia, V., Nemesure, B., Neovius, M., Nerhus, K., Nervi, F., Neuhauser, H., Nguyen, M., Ninomiya, T., Noale, M., Oh, S., Ohkubo, T., Olivieri, O., Önal, A., Onat, A., Oróstegui, M., Ouedraogo, H., Pan, W., Panagiotakos, D., Panza, F., Park, Y., Passos, V., Pednekar, M., Peres, M., Pérez, C., Pérez Fernández, R., Pichardo, R., Phua, H., Pistelli, F., Plans, P., Polakowska, M., Poulter, N., Prabhakaran, D., Qiao, Q., Rafiei, M., Raitakari, O., Ramos, L., Rampal, S., Rampal, L., Rasmussen, F., Reddy, K., Redon, J., Revilla, L., Reyes García, V., Roaeid, R., Rodriguez Artalejo, F., Rojas Martinez, R., Ronkainen, K., Rosero Bixby, L., Roth, G., Sachdev, H., Sánchez, J., Sanisoglu, S., Sans, S., Sarraf Zadegan, N., Scazufca, M., Schaan, B., Schapochnik, N., Schelleman, H., Schneider, I., Schooling, C., Schwarz, B., Sekuri, C., Sereday, M., Serra Majem, L., Shaw, J., Shera, A., Shi, Z., Shiri, R., Shu, X., Silva, D., Silva, E., Simons, L., Smith, M., Söderberg, S., Soebardi, S., Solfrizzi, V., Sonestedt, E., Soysal, A., Stattin, P., Stein, A., Stergiou, G., Stessman, J., Sudo, A., Suka, M., Sundh, V., Sundquist, K., Sundström, J., Swai, A., Tai, E., Tambs, K., Tesfaye, F., Thomas, G., Thorogood, M., Tilvis, R., Tobias, M., Torheim, L., Trenkwalder, P., Tuomilehto, J., Tur, J., Tzourio, C., Uhernik, A., Ukoli, F., Unwin, N., Vander Hoorn, S., Vanderpump, M., Varo, J., Veierød, B., Velásquez Meléndez, G., Verschuren, M., Viet, L., Villalpando, S., Vioque, J., Vollenweider, P., Volpato, S., Wang, N., Wang, Y., Ward, M., Waspadji, S., Welin, L., Wilhelmsen, L., Willeit, J., Woodward, M., Xavier, A., Xu, F., Xu, L., Yamamoto, A., Yang, G., Yang, X., Yeh, L., Yoon, J., You, Q., Yu, Z., Zhang, J., Zhang, L., Zheng, W., Zhou, M., Danaei G, Singh GM, Paciorek CJ, Lin JK, Cowan MJ, Finucane MM, Farzadfar F, Stevens GA, Riley LM, Lu Y, Rao M, Ezzati M and Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group, Aamodt G, Abdeen Z, Abdella NA, Rahim HF, Addo J, Aekplakorn W, Afifi MM, Agabiti-Rosei E, Aguilar Salinas CA, Agyemang C, Ali MM, Al-Nsour M, Al-Nuaim AR, Ambady R, Aro P, Azizi F, Barbagallo CM, Barbieri MA, Barceló A, Barreto SM, Barros H, Bautista LE, Benetos A, Bjerregaard P, Björkelund C, Bo S, Bobak M, Bonora E, Bontha BV, Botana MA, Bovet P, Breckenkamp J, Breteler MM, Broda G, Brown IJ, Bursztyn M, Cabrera de León A, Campos H, Cappuccio FP, Capuano V, Casiglia E, Castellano M, Castetbon K, Cea L, Chang CJ, Chaouki N, Chatterji S, Chen Z, Chen CJ, Choi JS, Chua L, Cífková R, Cobiac LJ, Cooper RS, Corsi AM, Costanza MC, Craig CL, Dankner RS, Dastgiri S, Delgado E, Dinc G, Doi Y, Dong GH, Dorsi E, Dragano N, Drewnowski A, Eggertsen W, Elliott P, Engeland A, Erem C, Esteghamati A, Fall CH, Fan JG, Ferreccio C, Fezeu L, Firmo JO, Florez HJ, Fornés NS, Fowkes FG, Franceschini G, Frisk F, Fuchs FD, Fuller EL, Getz L, Giampaoli S, Gómez LF, Gomez-Zumaquero JM, Graff-Iversen S, Grant JF, Guerrero Carvajal R, Gulliford MC, Gupta R, Gupta PC, Gureje O, Hansen TW, Hata J, He J, Heim N, Heinrich J, Hemmingsson T, Hennis A, Herman WH, Herrera VM, Ho S, Holdsworth M, Hollman Frisman G, Hopman WM, Hussain A, Husseini A, Ibrahim M, Ikeda N, Jacobsen BK, Jaddou HY, Jafar TH, Janghorbani M, Jasienska G, Joffres MR, Jonas JB, Kadiki OA, Kalter-Leibovici O, Kamadjeu RM, Karalis I, Kastarinen MJ, Katz J, Keinan-Boker L, Kelly P, Khalilzadeh O, Khang YH, Kiechl S, Kim KW, Kiyohara Y, Kobayashi J, Krause MP, Kubínová R, Kurjata P, Kusuma YS, Lam TH, Langhammer A, Lawes CM, Le C, Lee J, Lévy-Marchal C, Li Y, Lim S, Lim TO, Lin X, Lin CC, Lin HH, Lind L, Lissner L, Liu X, Lopez-Jaramillo P, Lorbeer R, Ma G, Ma S, Macià F, MacLean DR, Maggi S, Magliano DJ, Makdisse M, Mancia G, Mannami T, Marques-Vidal P, Mbanya JC, McFarlane-Anderson N, Miccoli R, Miettola J, Minh HV, Miquel JF, Miranda J, Mohamed MK, Mohan V, Mohanna S, Mokdad A, Mollentze WF, Morales DD, Morgan K, Muiesan LM, Muntoni S, Nabipour I, Nakagami T, Nangia V, Nemesure B, Neovius M, Nerhus KA, Nervi F, Neuhauser H, Nguyen M, Ninomiya T, Noale M, Oh SW, Ohkubo T, Olivieri O, Önal AE, Onat A, Oróstegui M, Ouedraogo H, Pan WH, Panagiotakos DB, Panza F, Park Y, Passos VM, Pednekar MS, Peres MA, Pérez C, Pérez-Fernández R, Pichardo R, Phua HP, Pistelli F, Plans P, Polakowska M, Poulter N, Prabhakaran D, Qiao Q, Rafiei M, Raitakari OT, Ramos LR, Rampal S, Rampal L, Rasmussen F, Reddy KK, Redon J, Revilla L, Reyes-García V, Roaeid RB, Rodriguez-Artalejo F, Rojas-Martinez R, Ronkainen K, Rosero-Bixby L, Roth GA, Sachdev HS, Sánchez JR, Sanisoglu SY, Sans S, Sarraf-Zadegan N, Scazufca M, Schaan BD, Schapochnik N, Schelleman H, Schneider IJ, Schooling C, Schwarz B, Sekuri C, Sereday MS, Serra-Majem L, Shaw J, Shera AS, Shi Z, Shiri R, Shu XO, Silva DA, Silva E, Simons LA, Smith M, Söderberg S, Soebardi S, Solfrizzi V, Sonestedt E, Soysal A, Stattin P, Stein AD, Stergiou GS, Stessman J, Sudo A, Suka M, Sundh V, Sundquist K, Sundström J, Swai AB, Tai E, Tambs K, Tesfaye F, Thomas GN, Thorogood M, Tilvis RS, Tobias M, Torheim LE, Trenkwalder P, Tuomilehto JO, Tur JA, Tzourio C, Uhernik AI, Ukoli FA, Unwin N, Vander Hoorn S, Vanderpump MP, Varo JJ, Veierød B, Velásquez-Meléndez G, Verschuren M, Viet L, Villalpando S, Vioque J, Vollenweider P, Volpato S, Wang N, Wang YX, Ward M, Waspadji S, Welin LX, Wilhelmsen L, Willeit J, Woodward M, Xavier AJ, Xu F, Xu L, Yamamoto A, Yang G, Yang X, Yeh LC, Yoon JS, You Q, Yu Z, Zhang J, Zhang L, Zheng W, Zhou M, ACS - Amsterdam Cardiovascular Sciences, APH - Amsterdam Public Health, and Public and occupational health

Subjects
Gerontology, Adult, Male, Risk, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Measures of national income and output, Population, Hypercholesterolemia, OBESIDADE, Blood Pressure, Global Health, Body Mass Index, Age Distribution, Risk Factors, cardiovascular disease, Physiology (medical), Diabetes mellitus, risk factors, Epidemiology, medicine, Diabetes Mellitus, Humans, Obesity, Risk factor, Sex Distribution, education, Developing Countries, Cholesterolo, education.field_of_study, business.industry, Urbanization, Feeding Behavior, Middle Aged, medicine.disease, Blood pressure, Cholesterol, Socioeconomic Factors, Cardiovascular Diseases, Hypertension, Western World, Female, Cardiology and Cardiovascular Medicine, business, Body mass index, Demography
Abstract

Background— It is commonly assumed that cardiovascular disease risk factors are associated with affluence and Westernization. We investigated the associations of body mass index (BMI), fasting plasma glucose, systolic blood pressure, and serum total cholesterol with national income, Western diet, and, for BMI, urbanization in 1980 and 2008. Methods and Results— Country-level risk factor estimates for 199 countries between 1980 and 2008 were from a previous systematic analysis of population-based data. We analyzed the associations between risk factors and per capita national income, a measure of Western diet, and, for BMI, the percentage of the population living in urban areas. In 1980, there was a positive association between national income and population mean BMI, systolic blood pressure, and total cholesterol. By 2008, the slope of the association between national income and systolic blood pressure became negative for women and zero for men. Total cholesterol was associated with national income and Western diet in both 1980 and 2008. In 1980, BMI rose with national income and then flattened at ≈Int$7000; by 2008, the relationship resembled an inverted U for women, peaking at middle-income levels. BMI had a positive relationship with the percentage of urban population in both 1980 and 2008. Fasting plasma glucose had weaker associations with these country macro characteristics, but it was positively associated with BMI. Conclusions— The changing associations of metabolic risk factors with macroeconomic variables indicate that there will be a global pandemic of hyperglycemia and diabetes mellitus, together with high blood pressure in low-income countries, unless effective lifestyle and pharmacological interventions are implemented.

Published
2013

3. Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: A comparative risk assessment

Author

Danaei, G, Lu, Y, Singh, G, Carnahan, E, Stevens, G, Cowan, M, Farzadfar, F, Lin, J, Finucane, M, Rao, M, Khang, Y, Riley, L, Arian, D, Lim, S, Ezzati, M, Aamodt, G, Abdeen, Z, Abdella, N, Rahim, H, Addo, J, Aekplakorn, W, Afifi, M, Agabiti-Rosei, E, Salinas, C, Agyemang, C, Ali, M, Al-Nsour, M, Al-Nuaim, A, Ambady, R, Angelantonio, E, Aro, P, Azizi, F, Babu, B, Bahalim, A, Barbagallo, C, Barbieri, M, Barceló, A, Barreto, S, Barros, H, Bautista, L, Benetos, A, Bjerregaard, P, Björkelund, C, Bo, S, Bobak, M, Bonora, E, Botana, M, Bovet, P, Breckenkamp, J, Breteler, M, Broda, G, Brown, I, Bursztyn, M, de León, A, Campos, H, Cappuccio, F, Capuano, V, Casiglia, E, Castellano, M, Castetbon, K, Cea, L, Chang, C, Chaouki, N, Chatterji, S, Chen, C, Chen, Z, Choi, J, Chua, L, Cífková, R, Cobiac, L, Cooper, R, Corsi, A, Costanza, M, Craig, C, Dankner, R, Dastgiri, S, Delgado, E, Dinc, G, Doi, Y, Dong, G, Dorsi, E, Dragano, N, Drewnowski, A, Eggertsen, R, Elliott, P, Engeland, A, Erem, C, Esteghamati, A, Fall, C, Fan, J, Ferreccio, C, Fezeu, L, Firmo, J, Florez, H, Fornés, N, Fowkes, F, Franceschini, G, Frisk, F, Fuchs, F, Fuller, E, Getz, L, Giampaoli, S, Gómez, L, Gomez-Zumaquero, J, Iversen, S, Grant, J, Carvajal, R, Gulliford, M, Gupta, R, Gupta, P, Gureje, O, Gutierrez, H, Hansen, T, Hata, J, He, J, Heim, N, Heinrich, J, Hemmingsson, T, Hennis, A, Herman, W, Herrera, V, Ho, S, Holdsworth, M, Frisman, G, Hopman, W, Hussain, A, Husseini, A, Ibrahim, M, Ikeda, N, Jacobsen, B, Jaddou, H, Jafar, T, Janghorbani, M, Jasienska, G, Joffres, M, Jonas, J, Kadiki, O, Kalter-Leibovici, O, Kamadjeu, R, Kaptoge, S, Karalis, I, Kastarinen, M, Katz, J, Keinan-Boker, L, Kelly, P, Khalilzadeh, O, Kiechl, S, Kim, K, Kiyohara, Y, Kobayashi, J, Krause, M, Kubínová, R, Kurjata, P, Kusuma, Y, Lam, T, Langhammer, A, Lawes, C, Le, C, Lee, J, Lévy-Marchal, C, Lewington, S, Li, Y, Lim, T, Lin, X, Lin, C, Lin, H, Lind, L, Lissner, L, Liu, X, Lopez-Jaramillo, P, Lorbeer, R, Ma, G, Ma, S, Macià, F, Maclean, D, Maggi, S, Magliano, D, Makdisse, M, Mancia, G, Mannami, T, Marques-Vidal, P, Mbanya, J, McFarlane-Anderson, N, Miccoli, R, Miettola, J, Minh, H, Miquel, J, Miranda, J, Mohamed, M, Mohan, V, Mohanna, S, Mokdad, A, Mollentze, W, Morales, D, Morgan, K, Lorenza M Muiesan, N, Muntoni, S, Nabipour, I, Nakagami, T, Nangia, V, Nemesure, B, Neovius, M, Nerhus, K, Nervi, F, Neuhauser, H, Nguyen, M, Ninomiya, T, Noale, M, Oh, S, Ohkubo, T, Olivieri, O, Önal, A, Onat, A, Oróstegui, M, Ouedraogo, H, Pan, W, Panagiotakos, D, Panza, F, Park, Y, Passos, V, Pednekar, M, Pelizzari, P, Peres, M, Cynthia Pérez, N, Pérez-Fernández, R, Pichardo, R, Phua, H, Pistelli, F, Plans, P, Polakowska, M, Poulter, N, Prabhakaran, D, Qiao, Q, Rafiei, M, Raitakari, O, Ramos, L, Rampal, S, Rampal, L, Rasmussen, F, Reddy, K, Redon, J, Revilla, L, Reyes-García, V, Roaeid, R, Robinson, C, Rodriguez-Artalejo, F, Rojas-Martinez, R, Ronkainen, K, Rosero-Bixby, L, Roth, G, Sachdev, H, Sánchez, J, Sanisoglu, S, Sans, S, Sarraf-Zadegan, N, Scazufca, M, Schaan, B, Schapochnik, N, Schelleman, H, Schneider, I, Schooling, C, Schwarz, B, Sekuri, C, Sereday, M, Serra-Majem, L, Shaw, J, Shera, A, Shi, Z, Shiri, R, Shu, X, Silva, D, Silva, E, Simons, L, Smith, M, Söderberg, S, Soebardi, S, Solfrizzi, V, Sonestedt, E, Soysal, A, Stattin, P, Stein, A, Stergiou, G, Stessman, J, Sudo, A, Suka, M, Sundh, V, Sundquist, K, Sundström, J, Swai, A, Tai, E, Tambs, K, Tesfaye, F, Thomas, G, Thorogood, M, Tilvis, R, Tobias, M, Torheim, L, Trenkwalder, P, Tuomilehto, J, Tur, J, Tzourio, C, Uhernik, A, Ukoli, F, Unwin, N, Hoorn, S, Vanderpump, M, Varo, J, Veierød, M, Velásquez-Meléndez, G, Verschuren, M, Viet, L, Villalpando, S, Vioque, J, Vollenweider, P, Volpato, S, Wang, N, Wang, Y, Ward, M, Waspadji, S, Lennart X Welin, N, Whitlock, G, Wilhelmsen, L, Willeit, J, Woodward, M, Wormser, D, André J Xavier, N, Xu, F, Xu, L, Yamamoto, A, Yang, G, Yang, X, Yeh, L, Yoon, J, You, Q, Yu, Z, Zhang, J, Zhang, L, Zheng, W, Zhou, M, Danaei, Goodarz, Lu, Yuan, Singh, Gitanjali M, Carnahan, Emily, Stevens, Gretchen A, Cowan, Melanie J, Farzadfar, Farshad, Lin, John K, Finucane, Mariel M, Rao, Mayuree, Khang, Young-Ho, Riley, Leanne M, Arian, Dariush Mozaff, Lim, Stephen S, Ezzati, Majid, Aamodt, Geir, Abdeen, Ziad, Abdella, Nabila A, Rahim, Hanan F Abdul, Addo, Juliet, Aekplakorn, Wichai, Afifi, Mustafa M, Agabiti-Rosei, Enrico, Salinas, Carlos A Aguilar, Agyemang, Charles, Ali, Mohammed K, Ali, Mohamed M, Al-Nsour, Mohannad, Al-Nuaim, Abdul R, Ambady, Ramachandran, Angelantonio, Emanuele Di, Aro, Pertti, Azizi, Fereidoun, Babu, Bontha V, Bahalim, Adil N, Barbagallo, Carlo M, Barbieri, Marco A, Barceló, Alberto, Barreto, Sandhi M, Barros, Henrique, Bautista, Leonelo E, Benetos, Athanase, Bjerregaard, Peter, Björkelund, Cecilia, Bo, Simona, Bobak, Martin, Bonora, Enzo, Botana, Manuel A, Bovet, Pascal, Breckenkamp, Juergen, Breteler, Monique M, Broda, Grazyna, Brown, Ian J, Bursztyn, Michael, de León, Antonio Cabrera, Campos, Hannia, Cappuccio, Francesco P, Capuano, Vincenzo, Casiglia, Edoardo, Castellano, Maurizio, Castetbon, Katia, Cea, Luis, Chang, Chih-Jen, Chaouki, Noureddine, Chatterji, Somnath, Chen, Chien-Jen, Chen, Zhengming, Choi, Jin-Su, Chua, Lily, Cífková, Renata, Cobiac, Linda J, Cooper, Richard S, Corsi, Anna Maria, Costanza, Michael C, Craig, Cora L, Dankner, Rachel S, Dastgiri, Saeed, Delgado, Elias, Dinc, Gonul, Doi, Yasufumi, Dong, Guang-Hui, Dorsi, Eleonora, Dragano, Nico, Drewnowski, Adam, Eggertsen, Robert, Elliott, Paul, Engeland, Anders, Erem, Cihangir, Esteghamati, Alireza, Fall, Caroline H D, Fan, Jian-Gao, Ferreccio, Catterina, Fezeu, Leopold, Firmo, Josélia O, Florez, Hermes J, Fornés, Nélida S, Fowkes, F Gerry R, Franceschini, Guido, Frisk, Fredrik, Fuchs, Flávio D, Fuller, Eva L, Getz, Linn, Giampaoli, Simona, Gómez, Luis F, Gomez-Zumaquero, Juan M, Iversen, Sidsel Graff, Grant, Janet F, Carvajal, Ramiro Guerrero, Gulliford, Martin C, Gupta, Rajeev, Gupta, Prakash C, Gureje, Oye, Gutierrez, Hialy R, Hansen, Tine W, Hata, Jun, He, Jiang, Heim, Noor, Heinrich, Joachim, Hemmingsson, Tomas, Hennis, Anselm, Herman, William H, Herrera, Victor M, Ho, Suzanne, Holdsworth, Michelle, Frisman, Gunilla Hollman, Hopman, Wilma M, Hussain, Akhtar, Husseini, Abdullatif, Ibrahim, M Mohsen, Ikeda, Nayu, Jacobsen, Bjarne K, Jaddou, Hashem Y, Jafar, Tazeen H, Janghorbani, Mohsen, Jasienska, Grazyna, Joffres, Michel R, Jonas, Jost B, Kadiki, Othman A, Kalter-Leibovici, Ofra, Kamadjeu, Raoul M, Kaptoge, Stephen, Karalis, Ioannis, Kastarinen, Mika J, Katz, Joanne, Keinan-Boker, Lital, Kelly, Paul, Khalilzadeh, Omid, Kiechl, Stefan, Kim, Ki Woong, Kiyohara, Yutaka, Kobayashi, Junji, Krause, Maressa P, Kubínová, Ružena, Kurjata, Pawel, Kusuma, Yadlapalli S, Lam, Tai H, Langhammer, Arnulf, Lawes, Carlene M M, Le, Cai, Lee, Jeannette, Lévy-Marchal, Claire, Lewington, Sarah, Li, Yanping, Li, Yuqiu, Lim, T O, Lin, Xu, Lin, Cheng-Chieh, Lin, Hsien-Ho, Lind, Lars, Lissner, Lauren, Liu, Xiaoqing, Lopez-Jaramillo, Patricio, Lorbeer, Roberto, Ma, Guansheng, Ma, Stefan, Macià, Francesc, Maclean, David R, Maggi, Stefania, Magliano, Dianna J, Makdisse, Marcia, Mancia, Giuseppe, Mannami, Toshifumi, Marques-Vidal, Pedro, Mbanya, Jean Claude N, McFarlane-Anderson, Norma, Miccoli, Roberto, Miettola, Juhani, Minh, Hoang V, Miquel, Juan F, Miranda, J Jaime, Mohamed, Mostafa K, Mohan, V., Mohanna, Salim, Mokdad, Ali, Mollentze, Willem F, Morales, Dante D, Morgan, Karen, Lorenza M Muiesan, null, Muntoni, Sergio, Nabipour, Iraj, Nakagami, Tomoko, Nangia, Vinay, Nemesure, Barbara, Neovius, Martin, Nerhus, Kjersti A, Nervi, Flavio, Neuhauser, Hannelore, Nguyen, Minh, Ninomiya, Toshiharu, Noale, Marianna, Oh, Sang W, Ohkubo, Takayoshi, Olivieri, Oliviero, önal, Ayse Emel, Onat, Altan, Oróstegui, Myriam, Ouedraogo, Hermann, Pan, Wen-Harn, Panagiotakos, Demosthenes B, Panza, Francesco, Park, Yongsoo, Passos, Valeria M A, Pednekar, Mangesh S, Pelizzari, Pamela M, Peres, Marco A, Cynthia Pérez, null, Pérez-Fernández, Román, Pichardo, Rafael, Phua, Hwee Pin, Pistelli, Francesco, Plans, Pedro, Polakowska, Maria, Poulter, Neil, Prabhakaran, Dorairaj, Qiao, Qing, Rafiei, Masoud, Raitakari, Olli T, Ramos, Luiz R, Rampal, Sanjay, Rampal, Lekhraj, Rasmussen, Finn, Reddy, Kanala K R, Redon, Josep, Revilla, Luis, Reyes-García, Victoria, Roaeid, Ragab B, Robinson, Carolyn A, Rodriguez-Artalejo, Fernando, Rojas-Martinez, Rosalba, Ronkainen, Kimmo, Rosero-Bixby, Luis, Roth, Gregory A, Sachdev, Harshpal S, Sánchez, José R, Sanisoglu, Selim Y, Sans, Susana, Sarraf-Zadegan, Nizal, Scazufca, Marcia, Schaan, Beatriz D, Schapochnik, Norberto, Schelleman, Hedi, Schneider, Ione J C, Schooling, C Mary, Schwarz, Bernhard, Sekuri, Cevad, Sereday, Martha S, Serra-Majem, Lluís, Shaw, Jonathan, Shera, Abdul S, Shi, Zumin, Shiri, Rahman, Shu, Xiao Ou, Silva, Diego Augusto Santos, Silva, Eglé, Simons, Leon A, Smith, Margaret, Söderberg, Stefan, Soebardi, Suharko, Solfrizzi, Vincenzo, Sonestedt, Emily, Soysal, Ahmet, Stattin, Pär, Stein, Aryeh D, Stergiou, George S, Stessman, Jochanan, Sudo, Akihiro, Suka, Machi, Sundh, Valter, Sundquist, Kristina, Sundström, Johan, Swai, Andrew B, Tai, E Shyong, Tambs, Kristian, Tesfaye, Fikru, Thomas, George N, Thorogood, Margaret, Tilvis, Reijo S, Tobias, Martin, Torheim, Liv E, Trenkwalder, Peter, Tuomilehto, Jaakko O, Tur, Josep A, Tzourio, Christophe, Uhernik, Ana I, Ukoli, Flora A, Unwin, Nigel, Hoorn, Stephen Vander, Vanderpump, Mark P, Varo, Jose Javier, Veierød, Marit B, Velásquez-Meléndez, Gustavo, Verschuren, Monique, Viet, Lucie, Villalpando, Salvador, Vioque, Jesus, Vollenweider, Peter, Volpato, Stefano, Wang, Ningli, Wang, Ya X, Ward, Mark, Waspadji, Sarwono, Lennart X Welin, null, Whitlock, Gary, Wilhelmsen, Lars, Willeit, Johann, Woodward, Mark, Wormser, David, André J Xavier, null, Xu, Fei, Xu, Liang, Yamamoto, Akira, Yang, Gonghuan, Yang, Xiaoguang, Yeh, Li-Chia, Yoon, Jin-Sang, You, Qisheng, Yu, Zhijie, Zhang, Jian, Zhang, Lei, Zheng, Wei, Zhou, Maigeng, Danaei, G, Lu, Y, Singh, G, Carnahan, E, Stevens, G, Cowan, M, Farzadfar, F, Lin, J, Finucane, M, Rao, M, Khang, Y, Riley, L, Arian, D, Lim, S, Ezzati, M, Aamodt, G, Abdeen, Z, Abdella, N, Rahim, H, Addo, J, Aekplakorn, W, Afifi, M, Agabiti-Rosei, E, Salinas, C, Agyemang, C, Ali, M, Al-Nsour, M, Al-Nuaim, A, Ambady, R, Angelantonio, E, Aro, P, Azizi, F, Babu, B, Bahalim, A, Barbagallo, C, Barbieri, M, Barceló, A, Barreto, S, Barros, H, Bautista, L, Benetos, A, Bjerregaard, P, Björkelund, C, Bo, S, Bobak, M, Bonora, E, Botana, M, Bovet, P, Breckenkamp, J, Breteler, M, Broda, G, Brown, I, Bursztyn, M, de León, A, Campos, H, Cappuccio, F, Capuano, V, Casiglia, E, Castellano, M, Castetbon, K, Cea, L, Chang, C, Chaouki, N, Chatterji, S, Chen, C, Chen, Z, Choi, J, Chua, L, Cífková, R, Cobiac, L, Cooper, R, Corsi, A, Costanza, M, Craig, C, Dankner, R, Dastgiri, S, Delgado, E, Dinc, G, Doi, Y, Dong, G, Dorsi, E, Dragano, N, Drewnowski, A, Eggertsen, R, Elliott, P, Engeland, A, Erem, C, Esteghamati, A, Fall, C, Fan, J, Ferreccio, C, Fezeu, L, Firmo, J, Florez, H, Fornés, N, Fowkes, F, Franceschini, G, Frisk, F, Fuchs, F, Fuller, E, Getz, L, Giampaoli, S, Gómez, L, Gomez-Zumaquero, J, Iversen, S, Grant, J, Carvajal, R, Gulliford, M, Gupta, R, Gupta, P, Gureje, O, Gutierrez, H, Hansen, T, Hata, J, He, J, Heim, N, Heinrich, J, Hemmingsson, T, Hennis, A, Herman, W, Herrera, V, Ho, S, Holdsworth, M, Frisman, G, Hopman, W, Hussain, A, Husseini, A, Ibrahim, M, Ikeda, N, Jacobsen, B, Jaddou, H, Jafar, T, Janghorbani, M, Jasienska, G, Joffres, M, Jonas, J, Kadiki, O, Kalter-Leibovici, O, Kamadjeu, R, Kaptoge, S, Karalis, I, Kastarinen, M, Katz, J, Keinan-Boker, L, Kelly, P, Khalilzadeh, O, Kiechl, S, Kim, K, Kiyohara, Y, Kobayashi, J, Krause, M, Kubínová, R, Kurjata, P, Kusuma, Y, Lam, T, Langhammer, A, Lawes, C, Le, C, Lee, J, Lévy-Marchal, C, Lewington, S, Li, Y, Lim, T, Lin, X, Lin, C, Lin, H, Lind, L, Lissner, L, Liu, X, Lopez-Jaramillo, P, Lorbeer, R, Ma, G, Ma, S, Macià, F, Maclean, D, Maggi, S, Magliano, D, Makdisse, M, Mancia, G, Mannami, T, Marques-Vidal, P, Mbanya, J, McFarlane-Anderson, N, Miccoli, R, Miettola, J, Minh, H, Miquel, J, Miranda, J, Mohamed, M, Mohan, V, Mohanna, S, Mokdad, A, Mollentze, W, Morales, D, Morgan, K, Lorenza M Muiesan, N, Muntoni, S, Nabipour, I, Nakagami, T, Nangia, V, Nemesure, B, Neovius, M, Nerhus, K, Nervi, F, Neuhauser, H, Nguyen, M, Ninomiya, T, Noale, M, Oh, S, Ohkubo, T, Olivieri, O, Önal, A, Onat, A, Oróstegui, M, Ouedraogo, H, Pan, W, Panagiotakos, D, Panza, F, Park, Y, Passos, V, Pednekar, M, Pelizzari, P, Peres, M, Cynthia Pérez, N, Pérez-Fernández, R, Pichardo, R, Phua, H, Pistelli, F, Plans, P, Polakowska, M, Poulter, N, Prabhakaran, D, Qiao, Q, Rafiei, M, Raitakari, O, Ramos, L, Rampal, S, Rampal, L, Rasmussen, F, Reddy, K, Redon, J, Revilla, L, Reyes-García, V, Roaeid, R, Robinson, C, Rodriguez-Artalejo, F, Rojas-Martinez, R, Ronkainen, K, Rosero-Bixby, L, Roth, G, Sachdev, H, Sánchez, J, Sanisoglu, S, Sans, S, Sarraf-Zadegan, N, Scazufca, M, Schaan, B, Schapochnik, N, Schelleman, H, Schneider, I, Schooling, C, Schwarz, B, Sekuri, C, Sereday, M, Serra-Majem, L, Shaw, J, Shera, A, Shi, Z, Shiri, R, Shu, X, Silva, D, Silva, E, Simons, L, Smith, M, Söderberg, S, Soebardi, S, Solfrizzi, V, Sonestedt, E, Soysal, A, Stattin, P, Stein, A, Stergiou, G, Stessman, J, Sudo, A, Suka, M, Sundh, V, Sundquist, K, Sundström, J, Swai, A, Tai, E, Tambs, K, Tesfaye, F, Thomas, G, Thorogood, M, Tilvis, R, Tobias, M, Torheim, L, Trenkwalder, P, Tuomilehto, J, Tur, J, Tzourio, C, Uhernik, A, Ukoli, F, Unwin, N, Hoorn, S, Vanderpump, M, Varo, J, Veierød, M, Velásquez-Meléndez, G, Verschuren, M, Viet, L, Villalpando, S, Vioque, J, Vollenweider, P, Volpato, S, Wang, N, Wang, Y, Ward, M, Waspadji, S, Lennart X Welin, N, Whitlock, G, Wilhelmsen, L, Willeit, J, Woodward, M, Wormser, D, André J Xavier, N, Xu, F, Xu, L, Yamamoto, A, Yang, G, Yang, X, Yeh, L, Yoon, J, You, Q, Yu, Z, Zhang, J, Zhang, L, Zheng, W, Zhou, M, Danaei, Goodarz, Lu, Yuan, Singh, Gitanjali M, Carnahan, Emily, Stevens, Gretchen A, Cowan, Melanie J, Farzadfar, Farshad, Lin, John K, Finucane, Mariel M, Rao, Mayuree, Khang, Young-Ho, Riley, Leanne M, Arian, Dariush Mozaff, Lim, Stephen S, Ezzati, Majid, Aamodt, Geir, Abdeen, Ziad, Abdella, Nabila A, Rahim, Hanan F Abdul, Addo, Juliet, Aekplakorn, Wichai, Afifi, Mustafa M, Agabiti-Rosei, Enrico, Salinas, Carlos A Aguilar, Agyemang, Charles, Ali, Mohammed K, Ali, Mohamed M, Al-Nsour, Mohannad, Al-Nuaim, Abdul R, Ambady, Ramachandran, Angelantonio, Emanuele Di, Aro, Pertti, Azizi, Fereidoun, Babu, Bontha V, Bahalim, Adil N, Barbagallo, Carlo M, Barbieri, Marco A, Barceló, Alberto, Barreto, Sandhi M, Barros, Henrique, Bautista, Leonelo E, Benetos, Athanase, Bjerregaard, Peter, Björkelund, Cecilia, Bo, Simona, Bobak, Martin, Bonora, Enzo, Botana, Manuel A, Bovet, Pascal, Breckenkamp, Juergen, Breteler, Monique M, Broda, Grazyna, Brown, Ian J, Bursztyn, Michael, de León, Antonio Cabrera, Campos, Hannia, Cappuccio, Francesco P, Capuano, Vincenzo, Casiglia, Edoardo, Castellano, Maurizio, Castetbon, Katia, Cea, Luis, Chang, Chih-Jen, Chaouki, Noureddine, Chatterji, Somnath, Chen, Chien-Jen, Chen, Zhengming, Choi, Jin-Su, Chua, Lily, Cífková, Renata, Cobiac, Linda J, Cooper, Richard S, Corsi, Anna Maria, Costanza, Michael C, Craig, Cora L, Dankner, Rachel S, Dastgiri, Saeed, Delgado, Elias, Dinc, Gonul, Doi, Yasufumi, Dong, Guang-Hui, Dorsi, Eleonora, Dragano, Nico, Drewnowski, Adam, Eggertsen, Robert, Elliott, Paul, Engeland, Anders, Erem, Cihangir, Esteghamati, Alireza, Fall, Caroline H D, Fan, Jian-Gao, Ferreccio, Catterina, Fezeu, Leopold, Firmo, Josélia O, Florez, Hermes J, Fornés, Nélida S, Fowkes, F Gerry R, Franceschini, Guido, Frisk, Fredrik, Fuchs, Flávio D, Fuller, Eva L, Getz, Linn, Giampaoli, Simona, Gómez, Luis F, Gomez-Zumaquero, Juan M, Iversen, Sidsel Graff, Grant, Janet F, Carvajal, Ramiro Guerrero, Gulliford, Martin C, Gupta, Rajeev, Gupta, Prakash C, Gureje, Oye, Gutierrez, Hialy R, Hansen, Tine W, Hata, Jun, He, Jiang, Heim, Noor, Heinrich, Joachim, Hemmingsson, Tomas, Hennis, Anselm, Herman, William H, Herrera, Victor M, Ho, Suzanne, Holdsworth, Michelle, Frisman, Gunilla Hollman, Hopman, Wilma M, Hussain, Akhtar, Husseini, Abdullatif, Ibrahim, M Mohsen, Ikeda, Nayu, Jacobsen, Bjarne K, Jaddou, Hashem Y, Jafar, Tazeen H, Janghorbani, Mohsen, Jasienska, Grazyna, Joffres, Michel R, Jonas, Jost B, Kadiki, Othman A, Kalter-Leibovici, Ofra, Kamadjeu, Raoul M, Kaptoge, Stephen, Karalis, Ioannis, Kastarinen, Mika J, Katz, Joanne, Keinan-Boker, Lital, Kelly, Paul, Khalilzadeh, Omid, Kiechl, Stefan, Kim, Ki Woong, Kiyohara, Yutaka, Kobayashi, Junji, Krause, Maressa P, Kubínová, Ružena, Kurjata, Pawel, Kusuma, Yadlapalli S, Lam, Tai H, Langhammer, Arnulf, Lawes, Carlene M M, Le, Cai, Lee, Jeannette, Lévy-Marchal, Claire, Lewington, Sarah, Li, Yanping, Li, Yuqiu, Lim, T O, Lin, Xu, Lin, Cheng-Chieh, Lin, Hsien-Ho, Lind, Lars, Lissner, Lauren, Liu, Xiaoqing, Lopez-Jaramillo, Patricio, Lorbeer, Roberto, Ma, Guansheng, Ma, Stefan, Macià, Francesc, Maclean, David R, Maggi, Stefania, Magliano, Dianna J, Makdisse, Marcia, Mancia, Giuseppe, Mannami, Toshifumi, Marques-Vidal, Pedro, Mbanya, Jean Claude N, McFarlane-Anderson, Norma, Miccoli, Roberto, Miettola, Juhani, Minh, Hoang V, Miquel, Juan F, Miranda, J Jaime, Mohamed, Mostafa K, Mohan, V., Mohanna, Salim, Mokdad, Ali, Mollentze, Willem F, Morales, Dante D, Morgan, Karen, Lorenza M Muiesan, null, Muntoni, Sergio, Nabipour, Iraj, Nakagami, Tomoko, Nangia, Vinay, Nemesure, Barbara, Neovius, Martin, Nerhus, Kjersti A, Nervi, Flavio, Neuhauser, Hannelore, Nguyen, Minh, Ninomiya, Toshiharu, Noale, Marianna, Oh, Sang W, Ohkubo, Takayoshi, Olivieri, Oliviero, önal, Ayse Emel, Onat, Altan, Oróstegui, Myriam, Ouedraogo, Hermann, Pan, Wen-Harn, Panagiotakos, Demosthenes B, Panza, Francesco, Park, Yongsoo, Passos, Valeria M A, Pednekar, Mangesh S, Pelizzari, Pamela M, Peres, Marco A, Cynthia Pérez, null, Pérez-Fernández, Román, Pichardo, Rafael, Phua, Hwee Pin, Pistelli, Francesco, Plans, Pedro, Polakowska, Maria, Poulter, Neil, Prabhakaran, Dorairaj, Qiao, Qing, Rafiei, Masoud, Raitakari, Olli T, Ramos, Luiz R, Rampal, Sanjay, Rampal, Lekhraj, Rasmussen, Finn, Reddy, Kanala K R, Redon, Josep, Revilla, Luis, Reyes-García, Victoria, Roaeid, Ragab B, Robinson, Carolyn A, Rodriguez-Artalejo, Fernando, Rojas-Martinez, Rosalba, Ronkainen, Kimmo, Rosero-Bixby, Luis, Roth, Gregory A, Sachdev, Harshpal S, Sánchez, José R, Sanisoglu, Selim Y, Sans, Susana, Sarraf-Zadegan, Nizal, Scazufca, Marcia, Schaan, Beatriz D, Schapochnik, Norberto, Schelleman, Hedi, Schneider, Ione J C, Schooling, C Mary, Schwarz, Bernhard, Sekuri, Cevad, Sereday, Martha S, Serra-Majem, Lluís, Shaw, Jonathan, Shera, Abdul S, Shi, Zumin, Shiri, Rahman, Shu, Xiao Ou, Silva, Diego Augusto Santos, Silva, Eglé, Simons, Leon A, Smith, Margaret, Söderberg, Stefan, Soebardi, Suharko, Solfrizzi, Vincenzo, Sonestedt, Emily, Soysal, Ahmet, Stattin, Pär, Stein, Aryeh D, Stergiou, George S, Stessman, Jochanan, Sudo, Akihiro, Suka, Machi, Sundh, Valter, Sundquist, Kristina, Sundström, Johan, Swai, Andrew B, Tai, E Shyong, Tambs, Kristian, Tesfaye, Fikru, Thomas, George N, Thorogood, Margaret, Tilvis, Reijo S, Tobias, Martin, Torheim, Liv E, Trenkwalder, Peter, Tuomilehto, Jaakko O, Tur, Josep A, Tzourio, Christophe, Uhernik, Ana I, Ukoli, Flora A, Unwin, Nigel, Hoorn, Stephen Vander, Vanderpump, Mark P, Varo, Jose Javier, Veierød, Marit B, Velásquez-Meléndez, Gustavo, Verschuren, Monique, Viet, Lucie, Villalpando, Salvador, Vioque, Jesus, Vollenweider, Peter, Volpato, Stefano, Wang, Ningli, Wang, Ya X, Ward, Mark, Waspadji, Sarwono, Lennart X Welin, null, Whitlock, Gary, Wilhelmsen, Lars, Willeit, Johann, Woodward, Mark, Wormser, David, André J Xavier, null, Xu, Fei, Xu, Liang, Yamamoto, Akira, Yang, Gonghuan, Yang, Xiaoguang, Yeh, Li-Chia, Yoon, Jin-Sang, You, Qisheng, Yu, Zhijie, Zhang, Jian, Zhang, Lei, Zheng, Wei, and Zhou, Maigeng

Abstract

Background: High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four cardiometabolic risk factors for all countries and regions from 1980 to 2010. Methods: We used data for exposure to risk factors by country, age group, and sex from pooled analyses of population-based health surveys. We obtained relative risks for the effects of risk factors on cause-specific mortality from meta-analyses of large prospective studies. We calculated the population attributable fractions for each risk factor alone, and for the combination of all risk factors, accounting for multicausality and for mediation of the effects of BMI by the other three risks. We calculated attributable deaths by multiplying the cause-specific population attributable fractions by the number of disease-specific deaths. We obtained cause-specific mortality from the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. We propagated the uncertainties of all the inputs to the final estimates. Findings: In 2010, high blood pressure was the leading risk factor for deaths due to cardiovascular diseases, chronic kidney disease, and diabetes in every region, causing more than 40% of worldwide deaths from these diseases; high BMI and glucose were each responsible for about 15% of deaths, and high cholesterol for more than 10%. After accounting for multicausality, 63% (10·8 million deaths, 95% CI 10·1-11·5) of deaths from these diseases in 2010 were attributable to the combined effect of these four metabolic risk factors, compared with 67% (7·1 million deaths, 6·6-7·6) in 1980. The mortality burden of high BMI and glucose nearly doubled from 1980 to 2010. At the country level, age-standardised death rates from these diseases attributable to the c

Published
2014

4. Diabetes

Author

Felding, P., Jensen, I., Manford, G., Linnet, K., Stahl, M., Jørgensen, L. G.M., Hyltoft Petersen, P., Brandslund, I., Olivarius de Fine, N., Borch-Johnsen, K., Ivanov, A., Zemtsovskaja, G., Nerhus, K., Kristensen, G., Sandberg, S., Brock, B., Gregersen, S., Hermansen, K., Felding, P., Jensen, I., Manford, G., Linnet, K., Stahl, M., Jørgensen, L. G.M., Hyltoft Petersen, P., Brandslund, I., Olivarius de Fine, N., Borch-Johnsen, K., Ivanov, A., Zemtsovskaja, G., Nerhus, K., Kristensen, G., Sandberg, S., Brock, B., Gregersen, S., and Hermansen, K.

Published
2000

5. Effect of ambient temperature on analytical performance of self-monitoring blood glucose systems.

Author

Nerhus K, Rustad P, and Sandberg S

Abstract

Abstract Background: The analytical quality of self-monitoring of blood glucose (SMBG) can be affected by environmental conditions such as temperature. The objective of this study was to determine the influence of (1) a shift in the ambient temperature immediately before measurement and (2) taking measurements in the lower and upper part of the operating temperature range. Methods: Nine different SMBG systems on the Norwegian market were tested with heparinized venous blood (4.8 and 19.0 mmol/L). To test the shift in ambient temperature effect, the glucometer and strips were equilibrated for 1 h at 5°C or 1 h at 30°C before the meter and strips were moved to room temperature, and measurements were performed after 0, 5, 10, 15, and 30 min. To test the lower and upper temperature range, measurements were performed at 10°C and at 39°C after 1 h for temperature equilibration of the glucometer and strips. All these measurements were compared with measurements performed simultaneously on a meter and strips kept at room temperature the whole time. Results: Six of nine SMBG systems overestimated and/or underestimated the results by more than 5% after moving meters and strips from 5°C or 30°C to room temperature immediately before the measurements. Two systems underestimated the results at 10°C. One system overestimated and another underestimated the results by more than 5% at 39°C. Conclusions: The effect on analytical performance was most pronounced after a rapid shift in the ambient temperature. Therefore patients need to wait at least 15 min for temperature equilibration of affected meters and strips before measuring blood glucose. [ABSTRACT FROM AUTHOR]

Published
2011
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7. Quality assessment of patients' self-monitoring of blood glucose in community pharmacies

Author

Reidun Lisbet Kjome, Ag, Granas, Nerhus K, and Sandberg S

Subjects
Health Care, lcsh:Pharmacy and materia medica, lcsh:Therapeutics. Pharmacology, Norway, Blood Glucose Self-Monitoring, lcsh:RM1-950, lcsh:RS1-441, Community Pharmacy Services, Quality Assurance
Abstract

Objective: To evaluate diabetes patients’ self-monitoring of blood glucose using a community pharmacy-based quality assurance procedure, to investigate whether the procedure improved the quality of the patient performance of self monitoring of blood glucose, and to examine the opinions of the patients taking part in the study. Methods: The results of patient blood glucose measurements were compared to the results obtained with HemoCue Glucose 201+ by pharmacy employees in 16 Norwegian community pharmacies. Patient performance was monitored using an eight item checklist. Patients whose blood glucose measurements differed from pharmacy measurements by more than 20% were instructed in the correct use of their glucometer. The patients then re-measured their blood glucose. If the results were still outside the set limits, the control procedure was repeated with a new lot of glucometer strips, and then with a new glucometer. The patients returned for a follow-up visit after three months. Results: During the first visit, 5% of the 338 patients had measurements that deviated from pharmacy blood glucose values by more than 20% and user errors were observed for 50% of the patients. At the second visit, there was no significant change in the analytical quality of patient measurements, but the percentage of patients who made user errors had decreased to 29% (p < 0.001). Eighty-five percent of the patients reported that they used their blood glucose results to adjust medication, exercise or meals. Fifty-one percent of the patients reported a greater trust in their measurements after the second visit. Eighty percent of patients wished to have their measurements assessed yearly. Of these patients, 83% preferred to have the assessment done at the community pharmacy. Conclusion: A community pharmacy-based quality assessment procedure of patients’ self monitoring of blood glucose significantly reduced the number of user errors. The analytical quality of the patients’ measurements was good and did not improve further during the study. The high analytical quality might be explained by a selection bias of participating patients. Patients also reported increased confidence in their blood glucose measurements after their measurements had been assessed at the pharmacy.

8. The prevalence of self-monitoring of blood glucose and costs of glucometer strips in a nationwide cohort.

Author

Kjome RL, Granas AG, Nerhus K, Roraas TH, and Sandberg S

Subjects
Adolescent, Adult, Aged, Blood Glucose Self-Monitoring economics, Diabetes Mellitus economics, Female, Humans, Male, Middle Aged, Norway, Prevalence, Retrospective Studies, Young Adult, Blood Glucose analysis, Blood Glucose Self-Monitoring methods, Diabetes Mellitus diagnosis, Reagent Strips economics
Abstract

Objective: This study used nationwide data to determine the prevalence of self-monitoring of blood glucose (SMBG) among all non-institutionalized persons living in Norway and to estimate the prevalence of SMBG among diabetes patients, the frequency and cost of SMBG, and the use of different glucometers., Methods: This retrospective, descriptive study is based on data of sales of glucometer strips to non-institutionalized persons in Norway in 2008. The data included gender, age group, month of purchase, sales place, type of strips, number of packages dispensed, and cost of strips. Additionally, statistics on sales of insulin and oral antidiabetes medications were obtained from the Norwegian Prescription Database., Results: A total of 96,999 persons purchased strips, a prevalence of 2%. Approximately 70% of diabetes patients practiced SMBG. An average patient used 1.7 strips per day, and younger patients purchased more strips than older patients. Fewer than 50% of patients performed glucose measurements daily. One percent of patients used more than 10 strips daily and was accountable for 8% of total costs. Most patients used only one type of strips, but the number of strips purchased increased with the number of different strips. The average annual cost of strips was 446 euro per person., Conclusions: Two percent of all non-institutionalized inhabitants and an estimated 70% of patients using diabetes medication purchased SMBG strips. A small percentage of the patients incurred a substantial proportion of the costs. This, along with the fact that over half of the patients monitor less than once per day, calls for tighter follow-up of diabetes patients.

Published
2010
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9. Implementation of a method for glucose measurements in community pharmacies.

Author

Kjome RL, Nerhus K, and Sandberg S

Subjects
Blood Glucose Self-Monitoring, Community Pharmacy Services economics, Family Practice statistics & numerical data, Humans, Program Development economics, Program Evaluation, Quality Assurance, Health Care methods, Quality Control, Blood Glucose analysis, Community Pharmacy Services statistics & numerical data
Abstract

Objectives: We aimed to implement a method for glucose measurements that could be used as a comparison method for asessing patients' self-monitoring of blood glucose. Further, we investigated whether pharmacies could achieve an analytical quality comparable to glucose measurements performed in general practice., Methods: Sixteen Norwegian pharmacy employees were trained in glucose measurement, quality control and blood sampling. The comparison method, HemoCue Glucose 201+, was validated in four steps: (1) estimation of the variation between the HemoCue instruments to be used at the 16 pharmacies, (2) comparison between HemoCue results and a laboratory glucose method, (3) monitoring quality by internal quality controls and (4) an external quality-assessment scheme. The pharmacies' results of the external quality assessment were compared to those of 359 general practices., Key Findings: The coefficient of variation for HemoCue instruments was 6.1% at the low level and 1.7% at the normal and high levels. Bias was negligible at the normal level. The coefficients of variation for internal quality controls were 4.5, 1.5 and 1.2% for the low, normal and high levels, respectively. All pharmacies achieved good precision and acceptable or good trueness in the external quality assessment. The pharmacies exhibited significantly lower variation between sites (2.2 and 1.2%) than general practices (3.8 and 2.9%) on both external quality-assessment samples., Conclusions: Given correct training and the establishment of a system of quality assurance, pharmacies are capable of obtaining glucose measurements that can be used as comparison measurements for controlling patients' meters. The pharmacies had external quality-assessment results comparable to general practice.

Published
2010
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10. Results and feasibility of an external quality assessment scheme for self-monitoring of blood glucose.

Author

Kristensen GB, Nerhus K, Thue G, and Sandberg S

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Child, Diabetes Mellitus, Type 1 diagnosis, Diabetes Mellitus, Type 2 diagnosis, Feasibility Studies, Female, Humans, Male, Middle Aged, Quality Control, Reference Standards, Blood Glucose Self-Monitoring standards
Abstract

Background: The analytical quality of self-monitoring of blood glucose (SMBG) is not satisfactory, and the need for standardized control routines for SMBG has been underscored. The objective of this study was to investigate whether an external quality assessment scheme (EQAS) designed for office laboratories could improve the quality of SMBG measurements., Methods: From October 2001 through March 2004, we conducted 6 glucose surveys for diabetes patients and coordinated them with an EQAS for office laboratories. Patients received 2 control samples by post twice a year. They measured each control sample in duplicate in accordance with written instructions, returned the results, and received an assessment of their analytical performance. Participants who got a poor evaluation were followed up by phone and were offered guidance., Results: Participating in an EQA program over a period of 3 years decreased the percentage of poor results among diabetes patients significantly, from 11.2% to 1.9% in the first and last surveys, respectively. Between-participant CVs improved from 5.5% to 3.7% and were comparable to results from office laboratories. It was difficult to sort out factors contributing to quality improvement., Conclusions: Implementing a traditional EQAS among diabetes patients may improve the analytical quality of SMBG and could be convenient for motivated patients. Further evaluation of the clinical usefulness of implementing such a program is needed, however, and costs as well as limitations of current EQAS for glucose in general should be taken into account.

Published
2006
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11. Standardized evaluation of instruments for self-monitoring of blood glucose by patients and a technologist.

Author

Kristensen GB, Nerhus K, Thue G, and Sandberg S

Subjects
Diabetes Mellitus, Type 1 blood, Diabetes Mellitus, Type 1 diagnosis, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 diagnosis, Humans, Medical Laboratory Personnel, Reference Standards, Blood Glucose Self-Monitoring instrumentation, Blood Glucose Self-Monitoring standards
Published
2004
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12. Instruments for self-monitoring of blood glucose: comparisons of testing quality achieved by patients and a technician.

Author

Skeie S, Thue G, Nerhus K, and Sandberg S

Subjects
Adult, Diabetes Mellitus diagnosis, Female, Humans, Male, Medical Laboratory Personnel, Middle Aged, Patients, Quality Control, Surveys and Questionnaires, Blood Glucose Self-Monitoring instrumentation
Abstract

Background: Instruments for self-monitoring of blood glucose (SMBG) are increasingly used by patients with diabetes. The analytical quality of meters in routine use is poorly characterized., Methods: We compared SMBG performance achieved by patients and by a medical laboratory technician. Imprecision was calculated from duplicate measurements, and deviation as the difference between the first measurement and the mean of duplicate laboratory-method results (calibrated with NIST material). Analytical quality for five groups of SMBG instruments was compared with quality specifications for BG measurements. All participants completed a questionnaire assessing both SMBG training and use of the meters., Results: We recruited 159 SMBG users from a hospital outpatient clinic and 263 others from 65 randomly selected general practices (total of 422). Most (two thirds) used insulin. CVs for the five meter types were 7%, 11%, 18%, 18%, and 20% in the hands of patients and 2.5-5.9% for the technician. For three of five meter types, patients' BG measurements had larger deviations from the laboratory results than did the technician's results. The technician's performance could not predict the patients'. No instrument when used by patients (but two operated by the technician) met published quality specifications. The analytical quality of patients' results was not related to whether they had chosen the instruments on advice from healthcare personnel (one-third of patients), were only self-educated in SMBG (50%), or performed SMBG fewer than seven times/week (62%)., Conclusions: The analytical quality of SMBG among patients was poorer than, and could not be predicted from, the performance of the meters in the hands of a technician. We suggest that new instruments be tested in the hands of patients who are trained on meter use in a routine way.

Published
2002

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