PMID- 30486848
OWN - NLM
STAT- MEDLINE
DCOM- 20190211
LR  - 20190315
IS  - 1744-8603 (Electronic)
IS  - 1744-8603 (Linking)
VI  - 14
IP  - 1
DP  - 2018 Nov 28
TI  - Sex differences and risk factors for diabetes mellitus - an international study 
      from 193 countries.
PG  - 118
LID - 10.1186/s12992-018-0437-7 [doi]
LID - 118
AB  - BACKGROUND: Increases in overweight and obesity among youths have resulted in the 
      diagnosis of Type 2 diabetes mellitus (T2DM) at earlier ages. The impact of 
      lifestyle-related factors has been implicated; however, its relation to morbidity 
      and mortality and sex differences remain unclear. We aimed to document the 
      changes in risk factors and sex differences associated with T2DM-related 
      morbidity and mortality during 1995-2015. METHOD: We used mortality rates and 
      morbidity estimates from the Global Burden of Diseases Study 2016 using 
      Disability-Adjusted Life Years (DALY). Multiple linear regression analyses were 
      used to determine associations between T2DM-related mortality and related risk 
      factors. DALYs were grouped by country income level, and were stratified by sex. 
      RESULTS: Increases in mortality were observed for both sexes, and females tended 
      to have higher mortality rates per 100,000 persons. Body mass index (BMI) 
      continued to be the leading risk factor for T2DM-related mortality, and increases 
      in BMI were more common in low- and middle-income countries (LIC and MIC). Low 
      physical activity was strongly associated with mortality rates, followed by 
      dietary risks and smoking (2.4; 1.4; 0.8 per 100,000 persons, respectively). 
      Similar patterns were observed after adjustments for income level, sex, and age. 
      DALYs continued to show increasing trends across all income levels during 
      1995-2015 (high-income (HIC):16%; MIC: 36%; LIC: 12%). Stratification by sex 
      showed similar results; males had fewer T2DM DALYs than females, though a greater 
      increase was observed among males. CONCLUSION: Overall, T2DM related mortality 
      was higher among females. Compared to in HIC, there appeared to be a considerable 
      increase in the burden of T2DM in MIC and LIC, where BMI is the leading risk 
      factor for T2DM-related mortality. Prevention programs should emphasize related 
      risk factors according to the existing standard of care.
FAU - Elling, Devy
AU  - Elling D
AUID- ORCID: 0000-0002-4452-8080
AD  - Department of Public Health Sciences, Stockholm University, Stockholm, Sweden. 
      devy.elling@su.se.
AD  - Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden. 
      devy.elling@su.se.
FAU - Surkan, Pamela J
AU  - Surkan PJ
AD  - Department of International Health, Johns Hopkins Bloomberg School of Public 
      Health, Baltimore, USA.
FAU - Enayati, Sahba
AU  - Enayati S
AD  - Kompetenzcenter Gesundheit, St. Stephan, Wels, Austria.
FAU - El-Khatib, Ziad
AU  - El-Khatib Z
AD  - Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
AD  - World Health Programme, Universite du Quebec en Abitibi-Temiscamingue (UQAT), 
      Quebec, Canada.
LA  - eng
PT  - Journal Article
DEP - 20181128
PL  - England
TA  - Global Health
JT  - Globalization and health
JID - 101245734
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Diabetes Mellitus, Type 2/*epidemiology
MH  - Female
MH  - Global Health/*statistics & numerical data
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Risk Factors
MH  - Sex Distribution
MH  - Young Adult
PMC - PMC6263066
OTO - NOTNLM
OT  - DALY
OT  - Diabetes mellitus
OT  - Global burden of disease
OT  - Mortality
OT  - Sex difference
COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Not applicable. CONSENT FOR 
      PUBLICATION: Not applicable. COMPETING INTERESTS: The authors declare that they 
      have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral 
      with regard to jurisdictional claims in published maps and institutional 
      affiliations.
EDAT- 2018/11/30 06:00
MHDA- 2019/02/12 06:00
PMCR- 2018/11/28
CRDT- 2018/11/30 06:00
PHST- 2018/09/24 00:00 [received]
PHST- 2018/11/08 00:00 [accepted]
PHST- 2018/11/30 06:00 [entrez]
PHST- 2018/11/30 06:00 [pubmed]
PHST- 2019/02/12 06:00 [medline]
PHST- 2018/11/28 00:00 [pmc-release]
AID - 10.1186/s12992-018-0437-7 [pii]
AID - 437 [pii]
AID - 10.1186/s12992-018-0437-7 [doi]
PST - epublish
SO  - Global Health. 2018 Nov 28;14(1):118. doi: 10.1186/s12992-018-0437-7.