| dc.description.abstract | Background. Type 2 Diabetes mellitus (T2DM) is a chronic progressive disease which
could lead to debilitating complications if not managed well. Therefore long term use of
anti diabetic medication is essential; this could eventually lead to increased health
burden. In this industrialized era T2DM prevalence had raised rapidly and additionally
the onset of disease has become at an early age. Latvia and Sri Lanka are developing
countries which are greatly affected by T2DM but unfortunately have limited financial
aid towards the health sector. Therefore it is important to find a method that is both,
optimizing patient health and is cost effective. Therefore in such circumstance identifying
the risk groups in each demographic area and focusing on them would be the best option
regarding the treatment plan.
Aims. Main objective was to determine the prevalence of risk factors of T2DM among
known diabetics in Sri Lanka and Latvia and to compare between the 2 different ethnic
groups. Furthermore the research is focused to assess difference in the age of onset of
T2DM between parent and offspring. Thereby elaborate on recommendations when
considering treatment and prevention of T2DM in each country.
Materials and methods. 430 T2DM patients, 224 from Sri Lanka (SL) and 206 from
Latvia (LV) took part in face to face interviews which were conducted using a structured
questionnaire followed by the measurement of waist and hip circumference.
Results. Significant association with a dominance in Sri Lanka was found in maternal
family history: SL vs. LV (37% vs.18 %, p<0.0001), paternal family history: SL vs. LV
(20% vs. 9 %, p=0.0001) and other family history: SL vs. LV (40% vs.10%, p<0.0001).
The factors that were predominant in Latvia were obesity, which was measured by BMI:
LV vs. SL (33.6±6.5 vs. 24.2±3.6, p<0.0001) or Waist to hip ratio: LV vs. SL (0.96±0.09
vs.0.92 ±0.07, p<0.0001) and associated diseases, patients with hypertension and
dyslipidemia: LV vs. SL (58% vs. 30 %, p<0.0001). There was a significant difference
among the alcohol consumption and smoking between the 2 countries, for example, those who didn’t take alcohol in LV vs. SL (59% vs. 73%, p=0.001), smoking in LV vs. SL
(31% VS. 21%, p=0.02). There was a significant difference regarding treatment with oral
antidiabetic drugs: SL vs. LV (81 % vs.29 %, p<0.0001), whereas insulin: SL vs. LV (7%
vs. 38 %, p<0.0001). If positive maternal family history, the age of onset of type 2
diabetes in offspring was earlier than in mother 44.6 ±11.4 vs. 55.2±10.5, p<0.0001 in SL
and the similar finding in LV: 51.6±8.4 vs. 58.2±15.3, p=0.003. In Sri Lanka age of
onset of father (57.49±11.88) and the age of onset of child (42.33 ±10.61) showed
significance p<0.0001 and Latvia age of onset of father (56.22±10.52) and age of onset of
child (47.67±8.77) p=0.01.Overall maternal transmission vs. paternal transmission SL
(36.6% vs. 25.1 %) p=0.0001, LV (18.4% vs. 9.6%) p=0.04 which was nearly significant.
Conclusions- There is significant demographical differences in the distribution of risk
factors of T2DM.Generally Sri Lanka seem to be affected at an earlier age when
compared to Latvia. Familial clustering is predominant with a prominent maternal
influence in transmission to the offspring. In Latvia obesity seem to be the predominant
risk factor among T2DM. To prevent the burden of diabetes and control diabetes-related
complications and to improve the quality of life for persons with T2DM, we should
educate the general public about life style modification programs, but most importantly
screening should be focused on those with a family history in Sri Lanka and those with a
BMI >30kgm² in Latvia so that we could get the maximum patient benefit from the
limited financial resources in preventing the progression of this disease and its
complications. | en_US |
| dc.description.abstract | Celonis. 2. tipa cukura diabets (T2DM) ir hroniska, progresejoša slimiba, kas atbilstoši
nearsteta var novest pie novajinošam komplikacijam. Tadel ilglaiciga antidiabetisko
medikamentu lietošana ir arkartigi svariga; tas galu gala var novest pie palielinata sloga
uz veselibu. Musdienu industrializetaja laikmeta T2DM izplatiba strauji pieaugusi, bez
tam slimibas sakums tiek noverots agra vecuma. Latvija un Šrilanka ir attistibas valstis,
ko specigi ietekmejis T2DM, tacu diemžel šis valstis spej pieškirt visai ierobežotu
finanšu palidzibu veselibas aizsardzibas sektoram. Tadel ir svarigi atrast metodi, kas
palidzetu gan optimizet pacientu veselibas stavokli, gan ari butu rentabla. Šados apstaklos
riska grupu identificešana katra demografiskaja apgabala un koncentrešanas uz tam butu
labakais veids ka izstradat arstešanas planu.
Merki. Galvenais merkis ir noteikt T2DM riska faktoru izplatibu starp zinamajiem
diabetikiem Šrilanka un Latvija un izdarit salidzinajumu starp 2 atškirigam etniskam
grupam. Turklat petijuma merkis ir novertet atškiribu vecuma, kad sakas T2DM, starp
vecaku un vina atvasi. Tas dos iespeju izstradat ieteikumus, aplukojot T2DM arstešanas
un noveršanas iespejas katra no valstim.
Materiali un metodes. 430 T2DM pacienti, 224 no Šrilankas (SL) un 206 no Latvijas
(LV) nema dalibu personiskas intervijas, kas tika organizetas, izmantojot strukturizetu
anketu, pec tam, kad tika izmeriti vidukla un gurnu apkartmeri.
Rezultati. Butiska saikne parsvaram Šrilanka tika rasta mates gimenes vesture: SL pret
LV (37 % pret 18 %, p < 0,0001), teva gimenes vesture: SL pret LV (20 % pret 9 %, p =
0,0001) un cita gimenes vesture: SL pret LV (40 % pret 10 %, p < 0,0001). Latvija
dominejošie faktori bija tuklums, ko merija BMI: LV pret SL (33,6 ± 6,5 pret 24,2 ± 3,6,
p < 0,0001) vai vidukla pret gurniem proporcija: LV pret SL (0,96 ± 0,09 pret 0,92 ±
0,07, p < 0,0001) un ar to saistitas saslimšanas, pacienti ar hipertoniju un dislipidemiju:
LV pret SL (58 % pret 30 %, p < 0,0001). Tapat starp šim 2 valstim tika noverota butiska
atškiriba alkohola paterina un smekešana, piemeram, tie, kas nelietoja alkoholu LV pret SL (59 % pret 73 %, p = 0,001), smekeja LV pret SL (31 % pret 21 %, p = 0,02). Pastav
butiska atškiriba attieciba uz arstešanu ar oralam antidiabetiskam zalem: SL pret LV (81
% pret 29 %, p < 0,0001), kamer insulins: SL pret LV (7 % pret 38 %, p < 0,0001). Ja ir
pozitiva mates gimenes vesture, 2. tipa diabeta sakuma vecums atvasei ir agraks neka
matei 44,6 ± 11,4 pret 55,2 ± 10,5, p < 0,0001 SL un lidzigi LV: 51,6 ± 8,4 pret 58,2 ±
15,3, p = 0,003. Šrilanka teva saslimšanas vecuma (57,49 ± 11,88) un berna saslimšanas
sakuma vecuma (42,33 ± 10,61) noverota nozime p < 0,0001, un Latvija teva saslimšanas
sakuma vecums (56,22 ± 10,52) un berna saslimšanas sakuma vecums (47,67 ± 8,77) p =
0,01. Vispareja mates slimibas parnešana pret teva slimibas parnešanu SL (36,6 % pret
25,1 %) p = 0,0001, LV (18,4 % pret 9,6 %) p = 0,04, kas ir ieverojami.
Secinajumi. T2DM riska faktoru izplatiba ir noverojamas butiskas demografiskas
atškiribas. Visa visuma Šrilanka cilveki saslimst agraka vecuma salidzinajuma ar Latviju.
Gimenes pulcešanas ir dominejoša ar ieverojamu mates ietekmi slimibas parnešana
atvasei. Latvija tuklums, škiet, ir butiskakais faktors T2DM saslimšana. Lai noverstu
diabeta slogu un kontroletu ar diabetu saistitas komplikacijas, ka ari lai uzlabotu dzives
kvalitati cilvekiem, kas sirgst ar T2DM, mums nepieciešams izglitot plašas laužu masas
par dzivesveida mainas programmam, tacu vissvarigak ir nodrošinat, lai skriningošana
koncentretos uz personam ar gimenes vesturi Šrilanka un personam ar BMI > 30 kgm²
Latvija ta, lai mes varetu sniegt maksimalu labumu pacientam ar ierobežotiem finanšu
resursiem, noveršot šis slimibas progresešanu un komplikacijas | en_US |
