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

ABSTRACT: 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).

SUBMITTER: Bodicoat DH

PROVIDER: S-EPMC4275673 | biostudies-literature | 2014 Dec

REPOSITORIES: biostudies-literature

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

Bodicoat Danielle H DH O'Donovan Gary G Dalton Alice M AM Gray Laura J LJ Yates Thomas T Edwardson Charlotte C Hill Sian S Webb David R DR Khunti Kamlesh K Davies Melanie J MJ Jones Andrew P AP

BMJ open 20141223 12

<h4>Objective</h4>To investigate the relationship between neighbourhood greenspace and type 2 diabetes.<h4>Design</h4>Cross-sectional.<h4>Setting</h4>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.<h4>Participants</h4>10,476 individuals (6200 from general population; ...[more]

PMID: 25537783

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Project description:ObjectivesThe aims of this study were to investigate circulating levels of inflammatory markers in adolescents with type 1 diabetes with and without different types of neuropathies and evaluate the association between inflammatory biomarkers, nerve function and clinical parameters.DesignCross-sectional study.SettingHospitals and Steno Diabetes Center in Denmark.ParticipantsAdolescents with more than 5 years of diabetes duration were investigated for large fibre, small fibre and autonomic neuropathy as a part of the T1DANES study. Blood samples from the participants were analysed for inflammatory biomarkers by Meso Scale Discovery multiplexing technology.Primary and secondary outcome measuresInflammatory biomarkers and results of diagnostic nerve tests.ResultsFifty-six adolescents with type 1 diabetes and 23 healthy controls were included. The adolescents with diabetes had significantly higher interferon-gamma, tumour necrosis factor-alpha (TNF-a), interleukin (IL)-10 and soluble urokinase plasminogen activator receptor (suPAR) compared with healthy controls (p values<0.05). TNF-a was higher in the adolescents with large fibre neuropathy (LFN) (p=0.03) compared with those without LFN in the group with diabetes. A negative correlation was seen between TNF-a and conduction velocity in nervus tibialis (p=0.04), and higher TNF-a and IL-6 were associated with higher gastric motility index (TNF-a, p value=0.03; IL-6, p value=0.02). There were no significant associations between inflammatory markers and expressed symptoms, haemoglobin A1c, diabetes duration or body mass index standard derivation score (p values>0.05). The receiver operating characteristic (ROC) curves for the inflammatory markers suggested them as poor screening methods for all types of neuropathies with an area under the curve between 0.47 and 0.67.ConclusionOur results confirm increased low-grade inflammation in adolescents with type 1 diabetes. TNF-a was higher in adolescents with LFN and correlated negatively with nervus tibialis conduction velocity. The other inflammatory biomarkers fail to support differences in those with and without different types of diabetic neuropathies. However, TNF-a and IL-6 were positively correlated to gastric motility index.

Project description:Objective This study aimed to explore the association between DM knowledge and self-efficacy in Chinese patients with T2DM. The influence factors for DM knowledge were explored, and evidence on interventions was provided to patients for information. Design A cross-sectional survey was conducted in various hospitals in Hunan Province, China, from April 2017 to February 2019, by using multistage stratified randomized sampling. DM knowledge and self-efficacy were measured using the Audit of Diabetes Knowledge (ADKnowl) and the General Self-efficacy (GSE) Scale. The relationship between the ADKnowl and the GSE scores was analyzed using the Spearman correlation analysis. Differences in the ADKnowl and GES scores among groups with different sociodemographic characteristics were computed; significant variables and GES scores were input in the multiple stepwise linear regression model to predict the influencing factors of ADKnowl scores. Results A total of 1,512 eligible patients with T2DM were included in this study, and their mean ADKnowl score was 59.04?±?16.24. The top score of the eight dimensions in the ADKnowl scale was reducing the complication risk by 71.01%. The mean GSE score was 2.42?±?0.59. The Spearman correlation analysis showed that the GSE score displayed a significantly positive correlation with DM knowledge at the ADKnowl scale (r?=?0.172, P < 0.001). The best fit multivariable linear regression analysis revealed eight variables that explained 37.6% of the variance of ADKnowl scores. They were diabetes-learning experience, educational background, complication, therapy, waist-to-hip ratio, diabetes duration, marital status, and GSE (R2?=?0.376, F?=?5.971, P=0.015). Conclusions In Chinese patients with T2DM, the self-efficacy in managing DM positively influenced DM knowledge. DM knowledge, as a protective factor, conversely improved the efficiency of self-management for T2DM. Some ignored influence factors in previous studies can be showed by investigating and analyzing from two scales. Health educators and promoters should help in developing DM knowledge and self-efficacy.

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

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

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