Prevalence of depressive symptoms among non insulin treated Greek type 2 diabetic subjects

<p>Abstract</p> <p>Background</p> <p>Depression is common among diabetic subjects. We conducted the present study to estimate the prevalence of depression in subjects with type 2 diabetes (T2D) in Greece.</p> <p>Methods</p> <p>The study sample consisted of 320 T2D subjects without overt macrovascular disease attending the diabetes outpatient clinic of our hospital, from June 2007 to December 2007. Depressive symptoms were measured using the 21-item Beck Depression Inventory, modified for use in diabetic subjects.</p> <p>Results</p> <p>Of the study subjects 107 (33.4%) reported elevated depressive symptoms. More women than men with diabetes reported symptoms of depression (48.4% vs. 12.7%, <it>P </it>< 0.001). In the female study group, depressive symptoms were correlated with HbA_1c(<it>P </it>= 0.04), and duration of diabetes (<it>P </it>= 0.004). In the male study group, univariate linear regression analysis showed no significant relationships between depressive symptoms and the testing variables.</p> <p>Conclusion</p> <p>The prevalence of depression in Greek T2D subjects is high. Diabetic female subjects showed increased levels of depressive symptoms compared with male subjects. Independent risk factors of depressive symptoms in diabetic female subjects were diabetes duration and glycemic control.</p

Prevalence of target organ damage in hypertensive subjects attending primary care: C.V.P.C. study (epidemiological cardio-vascular study in primary care)

<p>Abstract</p> <p>Background</p> <p>Except for the established risk factors, presence of target organ damage has an important role in the treatment of hypertensive subjects. The aim of the present study was to estimate the prevalence of target organ damage in primary care subjects.</p> <p>Methods</p> <p>This multi-centre, cross-sectional survey of 115 primary care physicians recruited 1095 consecutive subjects with hypertension: 611 men (55.8%); and 484 women (44.2%). A detailed history for the presence of cardiovascular disease and a thorough clinical examination was performed to each subject.</p> <p>Results</p> <p>Of the total study population, 44.5% (n = 487) had target organ damage (33.0% had left ventricular hypertrophy, 21.8% increased carotid intima media thickness, 11.0% elevated plasma creatinine levels and 14.6% microalbuminuria). Target organ damage was more prevalent in males than in females (P = 0.05). In addition, males had more often increased carotid intima media thickness than females (P = 0.009). On the contrary, females had more often microalbuminuria (P = 0.06) than males. No differences were observed between the two genders regarding left ventricular hypertrophy (P = 0.35) and elevated plasma creatinine levels (P = 0.21). Logistic regression analysis showed associations between target organ damage and dyslipidemia (P < 0.001), presence of metabolic syndrome (P = 0.005), diabetes (P < 0.001) and coronary artery disease (P < 0.001).</p> <p>Conclusion</p> <p>A significant proportion of hypertensive subjects in primary care had documented associated target organ damage, with left ventricular hypertrophy being the most prevalent target organ damage.</p

Self-medication with antibiotics in rural population in Greece: a cross-sectional multicenter study

<p>Abstract</p> <p>Background</p> <p>Self-medication is an important driver of antimicrobial overuse as well as a worldwide problem. The aim of the present study was to estimate the use of antibiotics, without medical prescription, in a sample of rural population presenting in primary care in southern Greece.</p> <p>Methods</p> <p>The study included data from 1,139 randomly selected adults (545 men/594 women, mean age ± SD: 56.2 ± 19.8 years), who visited the 6 rural Health Centres of southern Greece, between November 2009 and January 2010. The eligible participants were sought out on a one-to-one basis and asked to answer an anonymous questionnaire.</p> <p>Results</p> <p>Use of antibiotics within the past 12 months was reported by 888 participants (77.9%). 508 individuals (44.6%) reported that they had received antibiotics without medical prescription at least one time. The major source of self-medication was the pharmacy without prescription (76.2%). The antibiotics most frequently used for self-medication were amoxicillin (18.3%), amoxicillin/clavulanic acid (15.4%), cefaclor (9.7%), cefuroxim (7.9%), cefprozil (4.7%) and ciprofloxacin (2.3%). Fever (41.2%), common cold (32.0%) and sore throat (20.6%) were the most frequent indications for the use of self-medicated antibiotics.</p> <p>Conclusion</p> <p>In Greece, despite the open and rapid access to primary care services, it appears that a high proportion of rural adult population use antibiotics without medical prescription preferably for fever and common cold.</p

Voluntary self-poisoning as a cause of admission to a tertiary hospital internal medicine clinic in Piraeus, Greece within a year

BACKGROUND: Out of 1705 patients hospitalised for various reasons in the 3(rd) Internal Medicine Department of the Regional General Hospital of Nikaea, in Piraeus, 146(8,5%) persons were admitted for drug intoxication between November 1999 and November 2000. METHODS: On average, these persons [male 50(34,2%) – female 96(65,8%)] were admitted to the hospital within 3.7 hours after taking the drug. RESULTS: The drugs that were more frequently taken, alone or in combination with other drugs, were sedatives (67.1%), aspirins and analgesics (mainly paracetamol) (43.5%). 38.3% of patients had a mental illness history, 31.5% were in need of psychiatric help and 45.2% had made a previous suicide attempt. No death occurred during the above period and the outcome of the patients' health was normal. After mental state examination, the mental illnesses diagnosed were depression (20.96%), psychosis (15.32%), dysthymic disorder (16,2%), anxiety disorder (22.58%) and personality disorder (8.87%). CONCLUSIONS: Self-poisoning remains a crucial problem. The use of paracetamol and sedatives are particularly important in the population studied. Interpersonal psychiatric therapy may be a valuable treatment after people tried to poison themselves

Serum selenium levels do not differ in type 2 diabetic subjects with and without coronary artery disease

<p>Abstract</p> <p>Background</p> <p>The aim of the present study was to investigate whether selenium levels differ between type 2 diabetic subjects with and without coronary artery disease (CAD).</p> <p>Methods</p> <p>A total of 200 subjects with type 2 diabetes (100 with CAD and 100 without CAD), consecutively selected from the diabetes outpatient clinic of our hospital were enrolled into the study. A detailed medical history and a physical examination were obtained by all the participants.</p> <p>Results</p> <p>Serum selenium levels did not differ between diabetic subjects with and without CAD (102.40 ± 31.10 vs. 108.86 ± 33.88 microg/L, p = 0.16). In diabetic subjects with CAD multivariate linear regression analysis demonstrated significant independent associations between selenium and sex (beta = 0.21, p = 0.03) and glucose levels (beta = 0.25, p = 0.008). In diabetic subjects without CAD multivariate linear regression analysis demonstrated significant independent associations between selenium and peripheral artery disease (beta = 0.16, p = 0.05) and glucose levels (beta = -0.09, p = 0.05).</p> <p>Conclusion</p> <p>Serum selenium levels did not differ between diabetic subjects with and without CAD. In diabetic subjects with CAD, the only determinants of serum selenium levels were sex and glucose levels. In diabetic subjects without CAD the only determinants of serum selenium levels were peripheral artery disease and glucose levels.</p

Prevalence of asymptomatic bacteriuria in type 2 diabetic subjects with and without microalbuminuria

<p>Abstract</p> <p>Background</p> <p>Diabetic subjects, especially women, show high prevalence of asymptomatic bacteriuria (ASB). The aim of the present study was to evaluate the prevalence of ASB in subjects with type 2 diabetes mellitus (T2D) with and without microalbuminuria (MA).</p> <p>Findings</p> <p>A hundred diabetic subjects with MA (53 males/47 females, mean age ± standard deviation: 65.5 ± 11.1 years) and 100 diabetic subjects without MA (52 males/48 females, mean age ± standard deviation: 65.4 ± 11.3 years), consecutively attending the outpatient diabetes clinic of our hospital were recruited in the study. Subjects with overt diabetic nephropathy or nephropathy from other causes were excluded. In addition, subjects with symptoms of urinary track infection or use of antimicrobial drugs in the last 14 days were excluded by the study.</p> <p>Diabetic subjects with MA showed increased prevalence of ASB compared to diabetic subjects without MA (21% versus 8%, P < 0.001, respectively). <it>Escherichia coli </it>was the most prevalent pathogen isolated in diabetic subjects with and without MA (12% versus 3.0%, P = 0.01, respectively) followed by <it>Proteus mirabilis </it>(6% versus 5%, P = 0.75, respectively) and <it>Klebsiella </it>spp (5% versus 1%, P = 0.09, respectively). Univariate logistic analysis showed that ASB was associated with the presence of coronary artery disease [odds ratio (OR): 0.29, 95% Confidence Intervals (95% CI): 0.09-0.95, P = 0.04] and gender (OR: 0.09, 95% CI: 0.02-0.35, P < 0.001) in the diabetic study group with MA.</p> <p>Conclusions</p> <p>ASB is more prevalent among T2D subjects with MA. Screening for ASB is warranted in diabetic patients especially if pyuria is detected in urine analysis since ASB has been found to be a risk factor for developing symptomatic urinary tract infection.</p

Familial history of diabetes and clinical characteristics in Greek subjects with type 2 diabetes

<p>Abstract</p> <p>Background</p> <p>A lot of studies have showed an excess maternal transmission of type 2 diabetes (T2D). The aim, therefore, of the present study was to estimate the prevalence of familial history of T2D in Greek patients, and to evaluate its potential effect on the patient's metabolic control and the presence of diabetic complications.</p> <p>Methods</p> <p>A total of 1,473 T2D patients were recruited. Those with diabetic mothers, diabetic fathers, diabetic relatives other than parents and no known diabetic relatives, were considered separately.</p> <p>Results</p> <p>The prevalence of diabetes in the mother, the father and relatives other than parents, was 27.7, 11.0 and 10.7%, respectively. Patients with paternal diabetes had a higher prevalence of hypertension (64.8 vs. 57.1%, P = 0.05) and lower LDL-cholesterol levels (115.12 ± 39.76 vs. 127.13 ± 46.53 mg/dl, P = 0.006) than patients with diabetes in the mother. Patients with familial diabetes were significantly younger (P < 0.001), with lower age at diabetes diagnosis (P < 0.001) than those without diabetic relatives. Patients with a diabetic parent had higher body mass index (BMI) (31.22 ± 5.87 vs. 30.67 ± 5.35 Kg/m², P = 0.08), higher prevalence of dyslipidemia (49.8 vs. 44.6%, P = 0.06) and retinopathy (17.9 vs. 14.5%, P = 0.08) compared with patients with no diabetic relatives. No difference in the degree of metabolic control and the prevalence of chronic complications were observed.</p> <p>Conclusion</p> <p>The present study showed an excess maternal transmission of T2D in a sample of Greek diabetic patients. However, no different influence was found between maternal and paternal diabetes on the clinical characteristics of diabetic patients except for LDL-cholesterol levels and presence of hypertension. The presence of a family history of diabetes resulted to an early onset of the disease to the offspring.</p

Prevalence, and associated risk factors, of self-reported diabetes mellitus in a sample of adult urban population in Greece: MEDICAL Exit Poll Research in Salamis (MEDICAL EXPRESS 2002)

BACKGROUND: The continuous monitoring and future prediction of the growing epidemic of diabetes mellitus worldwide presuppose consistent information about the extent of the problem. The aim of this study was to determine the prevalence of diagnosed diabetes and to identify associated risk factors in a sample of adult urban Greek population. METHODS: A cross-sectional population-based survey was conducted in municipality of Salamis, Greece, during an election day (2002). The study sample consisted of 2805 participants, aged 20–94 years. Data were collected using a standardized short questionnaire that was completed by a face-to-face interview. Multiple regression analyses were performed to evaluate the association of diabetes with potential risk factors. RESULTS: The overall prevalence of diagnosed diabetes was 8.7% (95% CI 7.7–9.8%). After age adjustment for the current adult population (2001 census) of Greece, the projection prevalence was calculated to 8.2%. Multivariate logistic regression analysis identified as independent risk factors: increasing age (odds ratio, OR = 1.07, 95% CI 1.06–1.08), male sex (OR = 1.43, 95% CI 1.04–1.95), overweight and obesity (OR = 1.97, 95% CI 1.29–3.01 and OR = 3.76, 95% CI 2.41–5.86, respectively), family history of diabetes (OR = 6.91, 95% CI 5.11–9.34), hypertension (OR = 2.19, 95% CI 1.60–2.99) and, among women, lower educational level (OR = 2.62, 95% CI 1.22–5.63). The prevalence of overweight and obesity, based on self-reported BMI, were 44.2% and 18.4%, respectively. Moreover, the odds for diabetes in obese subjects with family history were 25-fold higher than those with normal weight and without family history of diabetes, while the odds in overweight subjects with family history of diabetes were 15-fold higher. CONCLUSIONS: Our findings indicated that the prevalence of diabetes is high in Greek population. It is suggested that the main modifiable contributing factor is obesity, whose effect is extremely increased upon positive heredity presence

The correlation of selenium and copper plasma levels with common cardiovascoular risk factors in type 2 diabetes mellitus patients

According to experimental and human studies, selenium and copper may have a key role in the pathogenesis of diabetes mellitus contributing to the insulin resistance and development of diabetic complications. Copper is an essential but highly-toxic trace metal that is closely related to increased pro-oxidant stress and defective antioxidant defenses, and to progressive damage to the blood vessels, heart, kidneys, retina and nerves. In non-diabetic subjects elevated copper levels have been related to coronary artery disease (CAD) and left ventricular dysfunction. Selenium is an essential trace element mainly involved in the complex system of defense against oxidative stress, thyroid function and immune functions. Studies have, also, showed a potential association between serum selemium levels and cardiovascular risk. The existing literature data regarding the relationship between serum selenium levels and type 2 diabetes (T2D) are controversial. Some studies showed that high serum selenium levels were positively associated with the prevalence of diabetes while other studies hypothesized that high levels of selenium might prevent diabetes. Therefore the aim of the present study was to investigate whether selenium and copper levels differ between T2D subjects with and without CAD.A total of 200 subjects with type 2 diabetes (100 with CAD and 100 without CAD), consecutively selected from the diabetes outpatient clinic of our hospital were enrolled into the study. A detailed medical history and a physical examination were obtained by all the participants. Statistical analysis was performed using programs available in the SPSS statistical package (SPSS 19.0, Chicago, USA).Serum selenium levels did not differ between diabetic subjects with and without CAD (102.40 ± 31.10 vs. 108.86 ± 33.88 microg/L, P=0.16). In diabetic subjects with CAD multivariate linear regression analysis demonstrated significant independent associations between selenium and sex (beta=0.21, P=0.03) and glucose levels (beta=0.25, P=0.008). In diabetic subjects without CAD multivariate linear regression analysis demonstrated significant independent associations between selenium and peripheral artery disease (beta=0.16, P=0.05) and glucose levels (beta=-0.09, P=0.05). In accordance, copper levels did not differ between diabetic subjects with and without CAD (115.60 ± 33.68 vs. 117.58 ± 33.79 microg/L, P=0.67). In diabetic subjects with CAD multivariate linear regression analysis demonstrated significant independent associations between copper and sex (beta=-0.22, P=0.05), body mass index (beta=0.25, P=0.01) and chronic kidney disease (beta=-0.22, P=0.01). In diabetic subjects without CAD multivariate linear regression analysis demonstrated significant independent associations between copper and hematocrit (beta=-0.19, P=0.05). In conclusion, serum selenium and copper levels did not differ between diabetic subjects with and without CAD. In diabetic subjects with CAD, the only determinants of serum selenium levels were sex and glucose levels while for copper was sex, body mass index and chronic kidney disease. In diabetic subjects without CAD the only determinants of serum selenium levels were peripheral artery disease and glucose levels while for copper was only hematocrit.Τα υψηλά επίπεδα του χαλκού σε μη διαβητικά άτομα έχουν συσχετισθεί με την παρουσία στεφανιαίας νόσου και δυσλειτουργίας της αριστεράς κοιλίας. Το σελήνιο είναι ένα ιχνοστοιχείο που μετέχει σε ποικίλα συστήματα όπως είναι η άμυνα έναντι της οξειδωτικής καταπόνησης, η λειτουργία του θυρεοειδούς αδένα και του ανοσοποιητικού συστήματος. Οι υπάρχουσες μελέτες έχουν δείξει την ύπαρξη συσχέτισης μεταξύ του σεληνίου και του καρδιαγγειακού κινδύνου. Τα υπάρχοντα βιβλιογραφικά δεδομένα σχετικά με το ρόλο του σεληνίου στο σακχαρώδη διαβήτη τύπου 2 (ΣΔτ2) παραμένουν αντικρουόμενα. Για τους παραπάνω λόγους σχεδιάσθηκε η παρούσα διδακτορική διατριβή προκειμένου να διερευνηθεί εάν τα επίπεδα σεληνίου και χαλκού πλάσματος διαφέρουν μεταξύ ατόμων με ΣΔτ2 ανάλογα με την παρουσία ή όχι στεφανιαίας νόσου (ΣΝ). Μελετήθηκαν 100 άτομα με ΣΔτ2 και ΣΝ και 100 άτομα με ΣΔτ2 χωρίς ΣΝ που επιλέχθηκαν τυχαία από το σύνολο των διαβητικών ατόμων που παρακολουθούνται στο Διαβητολογικό Κέντρο της Γ’ Παθολογικής Κλινικής του Γ.Ν.Νίκαιας. Όλοι υποβλήθηκαν σε πλήρη αντικειμενική εξέταση και εργαστηριακό έλεγχο.Τα επίπεδα σεληνίου του πλάσματος δε διέφεραν μεταξύ διαβητικών ατόμων με και χωρίς στεφανιαία νόσο (102,40 ± 31,10 έναντι 108,86 ± 33,88 microg/L,αντίστοιχα, P=0,16). Στα άτομα με ΣΔτ2 και ΣΝ η ανάλυση πολλαπλής γραμμικής εξάρτησης έδειξε ότι το φύλο (beta=0,21, P=0,03) και τα επίπεδα γλυκόζης του πλάσματος (beta=0,25, P=0,008) σχετίζονταν σημαντικά και ανεξάρτητα με τα επίπεδα σεληνίου του πλάσματος. Στα άτομα με ΣΔτ2 χωρίς ΣΝ η ανάλυση πολλαπλής γραμμικής εξάρτησης έδειξε ότι η παρουσία περιφερικής αγγειακής νόσου (beta=0,16, P=0,05) και τα επίπεδα γλυκόζης του πλάσματος (beta=-0,09, P=0,05) σχετίζονταν με τα επίπεδα σεληνίου του πλάσματος.Όμοια, τα επίπεδα χαλκού του πλάσματος δε διέφεραν μεταξύ διαβητικών ατόμων με και χωρίς ΣΝ (115,60 ± 33,68 έναντι 117,58 ± 33,79 microg/L, αντίστοιχα, P=0,67). Στα άτομα με ΣΔτ2 και ΣΝ η ανάλυση πολλαπλής γραμμικής εξάρτησης έδειξε ότι το φύλο (beta=-0,22, P=0,05), το BMI (beta=0,25, P=0,01) και η παρουσία χρόνιας νεφρικής νόσου (beta=-0,22, P=0,01) σχετίζονταν σημαντικά και ανεξάρτητα με τα επίπεδα χαλκού του πλάσματος. Στα άτομα με ΣΔτ2 χωρίς ΣΝ η ανάλυση πολλαπλής γραμμικής εξάρτησης έδειξε ότι ο αιματοκρίτης (P=0,05) σχετίζονταν με τα επίπεδα χαλκού του πλάσματος.Συμπερασματικά, τα αποτελέσματα της παρούσας διδακτορικής διατριβής έδειξαν ότι τα επίπεδα σεληνίου και χαλκού του πλάσματος δεν διέφεραν μεταξύ των ατόμων με ΣΔτ2 με και χωρίς ΣΝ. Στα διαβητικά άτομα με ΣΝ τα επίπεδα σεληνίου του πλάσματος σχετίζονταν με το φύλο και τα επίπεδα γλυκόζης πλάσματος ενώ τα επίπεδα χαλκού του πλάσματος σχετίζονταν με το φύλο, το δείκτη μάζας σώματος και την παρουσία χρόνιας νεφρικής νόσου. Στα διαβητικά άτομα χωρίς στεφανιαία νόσο τα επίπεδα σεληνίου του πλάσματος σχετίζονταν με την παρουσία περιφερικής αρτηριακής νόσου και τα επίπεδα γλυκόζης πλάσματος, ενώ τα επίπεδα χαλκού του πλάσματος σχετίζονταν μόνο με τον αιματοκρίτη