Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29–39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

Leadership in the transition from a socialist to a market economy : multi-stakeholder perceptions of business leadership in Vietnam

While Vietnam is a socialist country with a collectivist culture, it has been in transition toward a more market-oriented economy, but it is still within the control of government. Economic reform has been receptive to foreign investment (Nguyen, 2005), and the country can now be understood to represent a type of market-oriented socialism (Communist Party of Vietnam Central Committee, 2001; Nguyen, 2005; Harm, 2013). One of the fundamental changes in the economy was the development of different forms of enterprise governance, including state-owned enterprises (SOEs), foreign invested enterprises (FIEs), and privately owned enterprises (POEs).However, among these diverse types of organizations, perceptions of leadership have not yet been clearly explored. Vietnamese business leaders have lacked the knowledge and experience of operating businesses in market-driven economies and using Western management practices (Schermerhorn, 2000; Napier & Thomas, 2004; Napier, 2005). Further, the Marxist-Leninist Vietnamese education system that adopts a centrally planned socialist structure has focused on a production (rather than demand) economy. This has left Vietnamese business leaders insufficiently prepared to engage with Western business models or to compete effectively during international trade (Napier, 2005). Adoption of some Western business approaches has led to shifts in leadership styles in Vietnam, although this has not been clearly understood. The applicability of Western leadership theories to collectivist cultures, including Vietnam, has been a neglected area of leadership research. The importance and value of leadership is also regarded differently across cultures, but such distinctions are still relatively unknown (House et al., 2004). Leadership research has also neglected the opinions of stakeholders. While stakeholders’ perceptions of leadership are known to be complex and uncertain, at least in part due to varying cultural perspectives (House et al., 2004), stakeholders’ perceptions of leadership in collectivist cultures have not yet been adequately investigated