BackgroundMusculoskeletal pain in people with type 2 diabetes is a common issue even to this day. The study aimed to explore the 10-year cumulative incidence of musculoskeletal pain, the mean number of doctor visits for musculoskeletal pain, and the mean number of doctor visits for musculoskeletal pain by location in people with type 2 diabetes, compared with respective values for people without diabetes.MethodsThe study utilized a population-based retrospective cohort study design. The subjects were randomly obtained from the Taiwan National Health Insurance Research Database. The diabetic group included 6586 people with type 2 diabetes aged 18–50 years, while the non-diabetic group consisted of 32,930 age- and sex-matched people. Based on the medical records of individuals with musculoskeletal pain in the two groups from 2001 to 2010, the 10-year cumulative incidence of musculoskeletal pain, the mean number of doctor visits for musculoskeletal pain, and the mean number of doctor visits for musculoskeletal pain by location were calculated and compared, with the aim of identifying differences between the two groups.ResultsShowed that people in the diabetic group had a higher 10-year cumulative incidence of and a higher mean number of doctor visits for musculoskeletal pain than the non-diabetic group (p < 0.05). The relative risk (RR) of the 10-year cumulative incidence of musculoskeletal pain in the two groups was the highest (RR = 1.39) for people between 30 and 39 years of age. The mean number of doctor visits for musculoskeletal pain by location was significantly different between the two groups. However, the mean number of doctor visits for limb pain registered the largest difference between the two groups.ConclusionPeople with type 2 diabetes aged 18–50 years had a higher 10-year cumulative incidence of and a higher mean number of doctor visits for musculoskeletal pain than the non-diabetic group. Musculoskeletal pain might directly or indirectly interfere with or decrease the physical activity levels of people with diabetes. Therefore, it is important to detect and treat musculoskeletal pain early in order to promote physical activity and optimize blood sugar control.
To evaluate birth outcomes in women with hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM), we used insurance data of Taiwan to evaluate 11 adverse neonatal outcomes of infants born to women with HDP (N = 7775) and with both HDP and GDM (HDP/GDM) (N = 1946), comparing to women with neither disorder (N = 19,442), matched by age. The impacts of preeclampsia/eclampsia were also evaluated. Results showed that Caesarean section delivery was near 1.7-fold greater in the HDP/GDM and HDP groups than in comparisons. The preterm delivery rates were more than threefold greater in HDP/GDM group and HDP group than in comparisons with adjusted odds ratios (aORs) of 4.84 (95% confidence interval (CI) 4.34–5.40) and 3.92 (95% CI 3.65–4.21), respectively, followed by jaundice (aORs 2.95 (95% CI 2.63–3.33) and 1.90 (95% CI 1.76–2.06)), and small gestation age (SGA) (aORs 6.57 (95% CI 5.56–7.75) and 5.81 (95% CI 5.15–6.55)). Incidence rates of birth trauma, patent ductus arteriosus, atrial septal defect, respiratory distress syndrome, and neonatal hypoglycemia were also higher in the HDP/GDM and HDP groups than in the comparison group. Most adverse outcomes increased further in women with preeclampsia or eclampsia. In conclusion, women with HDP are at elevated risks of adverse neonatal outcomes. Risks of most adverse outcomes increase further for women with both HDP and GDM. Preeclampsia or eclampsia may also contribute to these outcomes to higher risk levels. Every pregnant woman with these conditions deserves specialized prenatal care.
Type 2 diabetes results from the body's ineffective use of insulin. Diabetes is a group of diseases marked by high levels of blood glucose resulting from defects in insulin production, insulin action, or both.Type 2 diabetes was previously called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes. According to 2011 National Diabetes Fact Sheet, diabetes affected 25.8 million people of all ages of United States population during 2005-2008, include 18.8 million diagnosed people and seven million undiagnosed people. Among United States residents ages 65 years and older, 10.9 million, or 26.9 percent, had diabetes in 2010. Recent World Health Organization (WHO) calculations indicate diabetes kills more than one million people annually, almost 80% of which occur in low- and middle-income countries. Almost half of diabetes deaths occur in people aged under 70 years; 55% of diabetes deaths are in women. WHO projects that diabetes deaths will double between 2005 and 2030.Type 2 diabetes is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race. It is a common outcome of uncontrolled blood sugar and over time leads to serious complications including hypertension, blindness, kidney damage, lower-limb amputations, heart disease, and stroke. Good glycaemic control is a major goal in the treatment of type 2 diabetes mellitus to prevent and delay those severe long-term complications. Physical activity is considered to be a substantial part of the treatment of type 2 diabetes mellitus, as well as diet and medication. Physical activity is a common physiological stressor that causes perturbation to glucose homeostasis and energy needs.Several studies have reported the effects of physical activity on improving insulin sensitivity, cardio-respiratory fitness, glycaemic control, and psychosocial well-being. The American Diabetes Association suggests that people with type 2 diabetes spend at least 150 minutes a week on moderate-intensity physical activity (50-70% of maximum heart rate), or at least 90 minutes a week on vigorous physical activity (>70% of maximum heart rate). Recent studies also indicate that moderate-intensity aerobic physical activity could help type 2 diabetes patients to maintain ideal glycaemic control. Boule et al found physical activity training could reduce haemoglobin A1c (HbA1c) (control group vs. exercise group: 8.31% vs. 7.65%) by 0.66%. This is close to the effect of intense glucose-lowering pharmacological treatment found in the United Kingdom Prospective Diabetes Study. A 1% absolute decrease in the HbA1c value is associated with a 15% to 20% decrease in major cardiovascular events and a 37% reduction in microvascular complications.According to Zhao, Ford, Chaoyang's report (2011), only 25-42% of older adults with diabetes mellitus met recommendations for total physical activity based on the 2007 American Diabetes Association and 2008 Department of Health and Human Services guideline...
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