Diabetic Medicine · 2011 · 42 citations · 10 references
MedicineHydrologyInternal MedicineDiabetologyEpidemiologyFlood HydrologyDiabetes ControlDiabetes ManagementDiabetes MellitusFlood Risk AssessmentGlycemic ControlUrban Flood ManagementDiabetes Medication UseDiabetes Mellitus ManagementFlood Health ResponseFlood-related Health RiskFloodingLongitudinal Case StudyLongitudinal Correlation StudyNatural Disaster Events
AIMS: To examine the impact of extensive flooding in a UK city in 2007 on the glycaemic control of patients with diabetes mellitus. METHODS: This was a longitudinal study in patients with diabetes mellitus 12 months before and after the floods in Hull and East Yorkshire, UK. All patients registered with diabetes mellitus were sent questionnaires about their experiences during and after the floods. Glycaemic control for patients directly affected by the floods was compared against those unaffected. RESULTS: Of 1743 respondents, 296 patients had been affected by the floods (110 insulin treated, 186 lifestyle and oral agents) and 1447 unaffected (482 insulin treated, 965 lifestyle and oral agents). There was a rise in mean HbA(1c) of affected individuals comparing 12 months before the floods with 12 months after [mean (95% confidence interval), 7.6% (7.5-7.7) vs. 7.9% (7.7-8.0), P = 0.002], but not those unaffected [7.5% (7.4-7.6) vs. 7.5% (7.4-7.6), P = 0.46]. The difference was mainly in insulin-treated patients [8.6% (8.3, 8.9) affected vs. 8.2% (8.1, 8.3) unaffected, (P = 0.002)]. CONCLUSIONS: Glycaemic control deteriorated in diabetes patients following the floods but was almost exclusively confined to patients taking insulin and was worst at 6-9 months following the event. Insulin-treated patients may need specific targeting in the event of a natural disaster.
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Some remarks on overdispersion
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Stress Management Improves Long-Term Glycemic Control in Type 2 Diabetes
Richard S. Surwit, Miranda A.L. van Tilburg, Nancy Zucker et al. · Diabetes Care · 2002 · 368 citations · Full text