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      Impact of Demographic, Socioeconomic, and Psychological Factors on Glycemic Self-Management in Adults with Type 2 Diabetes Mellitus

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          Abstract

          Diabetes mellitus (DM) is reported as one of the most complex chronic diseases worldwide. In the United States, Type 2 DM (T2DM) is the seventh leading cause of morbidity and mortality. Individuals with diabetes require lifelong personal care to reduce the possibility of developing long-term complications. A good knowledge of diabetes risk factors, including obesity, dyslipidemia, hypertension, family history of DM, and sedentary lifestyle, play an essential role in prevention and treatment. Also, sociodemographic, economic, psychological, and environmental factors are directly and indirectly associated with diabetes control and health outcomes. Our review intends to analyze the interaction between demographics, knowledge, environment, and other diabetes-related factors based on an extended literature search, and to provide insight for improving glycemic control and reducing the incidence of chronic complications.

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          The relationship of depression and diabetes: pathophysiological and treatment implications.

          Diabetes is a highly prevalent, chronic disease that requires ongoing, multi-specialty medical care combined with patient self-management, family support, and education to prevent or delay end-organ morbidity and mortality. There is clearly an increased prevalence of major depressive disorder, a relatively common and costly central nervous system syndrome, in diabetic patients. During the past two decades, multiple studies reveal that not only are depressive symptoms a risk factor for the development of type 2 diabetes, but they have also been shown to contribute to hyperglycemia, diabetic complications, functional disability and all-cause mortality among diabetic patients. This article reviews studies examining the relationship between depression and diabetes, neurochemical underpinnings of the two disorders, and the diagnosis and treatment of depression associated with diabetes. We examine the validity of rating scales used to diagnose depression in diabetic patients and review the literature on psychotherapeutic and psychopharmacologic management for these patients. The challenges of optimal depression screening and treatment in primary care settings of diabetic patients are currently under close scrutiny, especially regarding their potential impact related to improvements in diabetes-related outcomes and decreased health care costs, be it "depression" or "diabetes" relevant. Much of the current literature regarding the intertwined nature of diabetes and depression is cross-sectional in nature. Future research should focus on longitudinal, prospective studies to determine causal factors. What is clear from the research reviewed in this article is that depression and diabetes should be treated together rather than as isolated diseases. The mind/body dualism is a false dichotomy and a truly team-based approach is necessary to address both issues of depression and diabetes. Collaborative care and the "patient-centered medical home" have emerged as potentially effective interventions to improve quality of care and patient outcomes in patients with depression and medical illnesses such as diabetes. Copyright © 2011 Elsevier Ltd. All rights reserved.
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            Diabetes Self-Management Education and Support in Type 2 Diabetes: A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics.

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              The association between neighbourhood greenspace and type 2 diabetes in a large cross-sectional study

              Objective To investigate the relationship between neighbourhood greenspace and type 2 diabetes. Design Cross-sectional. Setting 3 diabetes screening studies conducted in Leicestershire, UK in 2004–2011. The percentage of greenspace in the participant's home neighbourhood (3 km radius around home postcode) was obtained from a Land Cover Map. Demographic and biomedical variables were measured at screening. Participants 10 476 individuals (6200 from general population; 4276 from high-risk population) aged 20–75 years (mean 59 years); 47% female; 21% non-white ethnicity. Main outcome measure Screen-detected type 2 diabetes (WHO 2011 criteria). Results Increased neighbourhood greenspace was associated with significantly lower levels of screen-detected type 2 diabetes. The ORs (95% CI) for screen-detected type 2 diabetes were 0.97 (0.80 to 1.17), 0.78 (0.62 to 0.98) and 0.67 (0.49 to 0.93) for increasing quartiles of neighbourhood greenspace compared with the lowest quartile after adjusting for ethnicity, age, sex, area social deprivation score and urban/rural status (Ptrend=0.01). This association remained on further adjustment for body mass index, physical activity, fasting glucose, 2 h glucose and cholesterol (OR (95% CI) for highest vs lowest quartile: 0.53 (0.35 to 0.82); Ptrend=0.01). Conclusions Neighbourhood greenspace was inversely associated with screen-detected type 2 diabetes, highlighting a potential area for targeted screening as well as a possible public health area for diabetes prevention. However, none of the risk factors that we considered appeared to explain this association, and thus further research is required to elicit underlying mechanisms. Trial registration number This study uses data from three studies (NCT00318032, NCT00677937, NCT00941954).
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                Author and article information

                Contributors
                URI : http://frontiersin.org/people/u/287350
                URI : http://frontiersin.org/people/u/367193
                URI : http://frontiersin.org/people/u/265301
                URI : http://frontiersin.org/people/u/116347
                URI : http://frontiersin.org/people/u/185391
                Journal
                Front Public Health
                Front Public Health
                Front. Public Health
                Frontiers in Public Health
                Frontiers Media S.A.
                2296-2565
                12 September 2016
                2016
                : 4
                : 195
                Affiliations
                [1] 1Department of Anesthesiology, The Ohio State University Wexner Medical Center , Columbus, OH, USA
                Author notes

                Edited by: Gaetano Santulli, Columbia University, USA

                Reviewed by: Priyanka Agarwal, Cedars-Sinai Medical Center, USA; Jessica Gambardella, University of the Study of Salerno, Italy

                *Correspondence: Barbara Rogers, barbara.rogers@ 123456osumc.edu

                Specialty section: This article was submitted to Diabetes, a section of the journal Frontiers in Public Health

                Article
                10.3389/fpubh.2016.00195
                5018496
                27672634
                8c81b682-36e5-4126-9042-c4b8fad5ac24
                Copyright © 2016 Gonzalez-Zacarias, Mavarez-Martinez, Arias-Morales, Stoicea and Rogers.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 12 July 2016
                : 29 August 2016
                Page count
                Figures: 1, Tables: 0, Equations: 0, References: 60, Pages: 8, Words: 6063
                Categories
                Public Health
                Review

                diabetes mellitus,type 2 diabetes mellitus,social factors,glucose control,glycosylated hemoglobin

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