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Poor glycemic control in workers with diabetes mellitus in relation to long working hours: a cross-sectional study.

ABSTRACT: We aimed to investigate the association between working hours and poor glycemic control using a cross-sectional data from the Korea National Health and Nutrition Examination Survey (KNHANES). The participants who were medically diagnosed with diabetes mellitus by a physician were defined as diabetic patients, and patients with hemoglobin A1c (HbA1c) levels >9.0% were considered as "poorly controlled". The association of HbA1c level with working hours was examined by linear regression plot, using local regression line and logistic regression analyses. The local regression plot showed a smooth increasing pattern: the longer were the working hours, the higher were the HbA1c levels, even though it was not statistically significant. Odds ratios of working hours over 52?h per week were higher with the criterion of poor diabetic control (HbA1c >9.0%). The results were significant in elderly female workers (odds ratio 3.30, 95% confidence interval 1.19-9.18). Long working hours were associated with poor glycemic control, specifically among elderly female workers with diabetes.

SUBMITTER: Lee J

PROVIDER: S-EPMC7557411 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Poor glycemic control in workers with diabetes mellitus in relation to long working hours: a cross-sectional study.

Lee Jongin J Kim Hyoung-Ryoul HR Jang Tae-Won TW Lee Dong-Wook DW Jeong Chaiho C Kang Mo-Yeol MY

Industrial health 20200613 5

We aimed to investigate the association between working hours and poor glycemic control using a cross-sectional data from the Korea National Health and Nutrition Examination Survey (KNHANES). The participants who were medically diagnosed with diabetes mellitus by a physician were defined as diabetic patients, and patients with hemoglobin A1c (HbA1c) levels >9.0% were considered as "poorly controlled". The association of HbA1c level with working hours was examined by linear regression plot, using ...[more]

PMID: 32536633

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Project description:BackgroundCardiovascular disease (CVD) is the most common complication of diabetes mellitus (DM). To prevent morbidity and mortality among patients with type 2 diabetes mellitus (T2DM), optimization of glycemic status and minimizing CVD risk factors is essential. As Nepal has limited data on these CVD risk parameters, we assessed the prevalence of poor glycemic control, CVD risk factors, and their clustering among patients with T2DM.MethodsUsing a cross-sectional study design, we collected data of 366 patients with T2DM. We applied a multistage cluster sampling technique and used the WHO STEPS tools. Binary logistic and Poisson regression was applied to calculate odds and prevalence ratio of clustering of risk factors, considering P< 0.05 statistically significant.ResultsThe mean age of participants was 54.5±10.7 years and 208 (57%) were male. The prevalence of poor glycemic control was 66.4% (95% C.I: 61.5-71.2). The prevalence of smoking, alcohol users, inadequate fruit and vegetables intake and physical inactivity were 18% (95% C.I:14 to 21.9), 14.8% (95% C.I:11.1 to 18.4), 98.1% (95% C.I: 96.7-99.4), and 9.8% (95% C.I:6.7-12.8), respectively. Overall, 47.3% (95% C.I: 42.1-52.4) were overweight and obese, 59% (95% C.I: 52.9-63) were hypertensive, and 68% (95% C.I: 63.2-72.7) had dyslipidemia. Clustering of two, three, four, five and more than five risk factors was 12.6%, 30%, 30%,19%, and 8.7%, respectively. Four or more risk factors clustering was significantly associated with gender, age, level of education, T2DM duration, and use of medication. Risk factors clustering was significantly higher among males and users of anti-diabetic medications with prevalence ratio of 1.14 (95% C.I:1.05-1.23) and 1.09 (95% C.I: 1.09-1.18)], respectively.ConclusionsThe majority of the patients with T2DM had poor glycemic control and CVD risk factors. Policies and programs focused on the prevention and better management of T2DM and CVD risk factors should be implemented to reduce mortality in Nepal.

Project description:Background:Over the past two decades, the prevalence of diabetes has increased faster in low- and middle-income countries than in high-income countries. Regardless of the instant growth in the prevalence of diabetes in Ethiopia, up-to-date data regarding glycemic control and related complications of diabetes is inadequate. This study aimed to identify glycemic control and chronic complications and their determinants among ambulatory diabetic patients at Mizan-Tepi University Teaching Hospital (MTUTH). Methods:We conducted facility-based cross-sectional study from February 25 to March 25, 2019, at Mizan-Tepi University Teaching Hospital. Patients' demographic data, diabetes complications, and treatments were collected using pretested questionnaire and data abstraction format. Data was entered by using Epidata manager 4.0.2.101, and statistical analysis was done by SPSS version 21. Bivariate logistic regression was done to see the association between independent variables and glycemic control and complication. Multivariable logistic regression analyses using backward selection were done to identify the predictors of poor glycemic control and complication at a P-value of <0.05. Results:One hundred ambulatory diabetic patients were included in this study. The mean duration of diabetes and the mean age of the participants were 3.95±5.85 and 46.66±15.53 years, respectively. About 71 (71%) of the studied diabetic patients had uncontrolled fasting blood glucose (FBG) level. More than half of the diabetic patients (59%) developed chronic complications of diabetes. Low medication adherence (adjusted odds ratio (AOR)=11.78, 95%CI: 1.09-17.17) and inappropriate doses in the first, second, and third clinic visits (AOR=7.70, 95%CI: 1.79-33.01; AOR=8.09, 95%CI: 1.90-34.33; AOR=4.34, 95%CI: 1.09-17.17), respectively, were independent predictors of uncontrolled FBG. No variable was found to be an independent predictor of chronic diabetic complication on multivariable logistic regression analyses. Conclusion:Poor glycemic control and diabetes complications among ambulatory diabetic patients were high. Low medication adherence and inappropriate doses in the first, second, and third clinic visits were independent predictors of poor glycemic control.

Project description:ObjectiveTo assess the rate of glycemic control and associated factors among type 2 diabetes mellitus patients at Dilchora Referral Hospital, Dire Dawa, Eastern Ethiopia.MethodsA cross-sectional study was conducted from 13 May to 16 August 2019. Type 2 diabetic patients on follow up at Dilchora Referral Hospital who fulfilled the inclusion criteria of the study were included. Systematic random sampling was used to select study participants. Data was collected by a face-to-face interview and review of medical records. The primary outcome was the level of blood glucose during three consecutive visits. Poor glycemic control was defined as a blood sugar level of more than 154 mg/dL based on the average of measurements from three consecutive visits. Multivariate logistic regression analysis was used to identify determinants of glycemic control.ResultA total of 394 participants responded to the interview and were included in the final analysis. The overall prevalence of poor glycemic control was 45.2% (95%CI: 40.6%-50.0%). Patients who were on oral anti-diabetic drug plus insulin had more than two times greater chance of poor glycemic control than patients on oral anti-diabetic drug alone: 2.177(95%CI:1.10-4.29). The odds of poor glycemic control in patients who did not understand the pharmacist's instructions was two times higher than patients with good understanding of instructions 1.86(95%CI: 1.10-3.13). Patients who had poor level of practice were found to have poor glycemic control: 1.69(95% CI: 1.13-2.55).ConclusionThe overall prevalence of poor glycemic control was high among type 2 diabetes patients. Oral anti-diabetic drugs in combination with insulin, lack of understanding of pharmacist's advice, and poor practice of diabetic patients were significant factors of poor glycemic control. Pharmacists should reassure the understanding of patients before discharge during counseling. Optimization of the dose of antidiabetic medications and combination of oral hypoglycemic agents should be considered.

Project description:ObjectiveLong working hours have been shown to raise the risk of various health outcomes. However, epidemiological evidence has shown inconsistent result in relation to type 2 diabetes mellitus (T2DM) and the association between long working hours and pre-diabetes among non-diabetic adults remains largely unexplored. We thus aimed to investigate whether long working hours were linked with pre-diabetes as determined by glycated haemoglobin (HbA1c) level.DesignCross-sectional survey.ParticipantsThis study included 6324 men and 4001 women without diabetes from the 2010 to 2017 Korean National Health and Nutrition Examination Survey.Primary outcome measuresThe study outcome of interest was pre-diabetes, defined as HbA1c values 5.7% to 6.4% RESULTS: Logistic regression was performed to obtain the ORs for pre-diabetes according to categories of work hour (40 hours/week, 41 to 52 hours/week, >52 hours/week), after adjusting for relevant covariates. Of the 10 325 eligible participants, 2261 (34.4%) men and 1317 (31.0%) women had pre-diabetes. No statistically significant relationship was found for women. In men, extended working hours (>52 hours per week) was associated with an increased likelihood of pre-diabetes, after adjustment for age, educational attainment, monthly household income, lifestyle related factors, perceived stress, family history of diabetes, hypertension, hypercholesterolaemia and other covariates (adjusted OR=1.22; 95% CI 1.03 to 1.46). In the subgroup analysis by occupational categories, the association was only apparent among men in blue-collar worker groups.ConclusionExtended working hours were significantly related to pre-diabetes in men, with no statistically significant association observed for women. Further subgroup analysis by occupational categories revealed that the increased odds of pre-diabetes associated with long working hours was only apparent among male workers of blue-collar occupations and shift workers.

Project description:ObjectivesThis study aimed to determine the cross-sectional association between long working hours and gastritis diagnosed by endoscopy.DesignCross-sectional study.SettingLarge university hospitals in Seoul and Suwon, South Korea.ParticipantsWorkers in formal employment who underwent a comprehensive health examination at the Kangbuk Samsung Hospital Total Healthcare Centre clinics in Seoul and Suwon, South Korea, between January 2011 and December 2018. Of the 386 488 participants, 168 391 full-time day workers met the inclusion criteria and were included in the analysis.Primary outcome measureEndoscopic gastritis.ResultsThe participants were predominantly college graduates or above (88.9%), male (71.2%) and in their 30s (51.1%), and the median age was 36 (IQR 31-42). Approximately 93.2% of participants had positive endoscopic gastritis, and there was a significant association between working hours and positive findings of endoscopic gastritis. The multivariate fully adjusted prevalence ratio (PR) of endoscopic gastritis for participants working >55 hours per week compared with 35-40 hours per week was 1.011 (95% CI 1.007 to 1.015). Furthermore, endoscopic findings were classified into nine subtypes of gastritis, including superficial gastritis, erosive gastritis, atrophic gastritis, intestinal metaplasia and haemorrhagic gastritis increased with longer working hours (p for trends <0.05). Their PRs for participants working >55 hours per week compared with 35-40 hours per week were 1.019 (95% CI 1.012 to 1.026), 1.025 (95% CI 1.011 to 1.040), 1.017 (95% CI 1.008 to 1.027), 1.066 (95% CI 1.028 to 1.105) and 1.177 (95% CI 1.007 to 1.375), respectively.ConclusionsWorking over 55 hours per week was cross-sectionally associated with positive findings of endoscopic gastritis. The study findings indicated potentially increased risks of superficial gastritis, erosive gastritis, atrophic gastritis, intestinal metaplasia and haemorrhagic gastritis among workers with long working hours (>55 hours per week), supporting the need for further exploration via longitudinal studies.

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Poor glycemic control in workers with diabetes mellitus in relation to long working hours: a cross-sectional study.

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Poor glycemic control in workers with diabetes mellitus in relation to long working hours: a cross-sectional study.

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