Smith Jessica, Martin Abey, Mundadan Jane, Roberts Michael, Roman Youssef, Bravo-Nuevo Arturo, Daghigh Farzaneh
Philadelphia College of Osteopathic Medicine, Philadelphia, USA.
Michigan State University College of Osteopathic Medicine, East Lansing, USA.
Diabetol Metab Syndr. 2025 Jan 21;17(1):25. doi: 10.1186/s13098-025-01586-y.
Underserved and underrepresented populations often lack access to affordable, quality healthcare, educational resources, and nutritious foods, all of which contribute to increased risk of Type 2 Diabetes and gout. Type 2 Diabetes is a condition characterized by the denaturation of the insulin receptors, due to chronically high blood glucose levels, leading to impaired regulation of blood sugar. Gout is a chronic inflammatory disease affecting joints in the lower limbs, marked by elevated serum urate levels and the accumulation of uric acid crystals in synovial fluid, causing painful flare-ups that significantly impact quality of life.
This multisite cross-sectional study was conducted in three low-income senior residential communities across the mid-Atlantic United States, including Philadelphia and Harrisburg, Pennsylvania, and Clinton, Maryland. A total of 88 consenting participants were surveyed on their health history and tested for hemoglobin A1c (HbA1c), blood glucose, and uric acid levels using finger-stick blood tests and commercially available devices. Inclusion criteria included individuals of any gender, aged 35-92, residing in these communities. Exclusion criteria were a personal history of cancer, organ transplantation, or current pregnancy. Educational materials were provided after discussing each participant's results.
There is an identifiable prevalence of gout among this population of low-income senior adults living with Type 2 Diabetes. Among the participants, 30.7% had serum urate levels indicative of hyperuricemia, exceeding the national average of 20.1% as reported by the National Health and Nutrition Examination Survey. Participants with high HbA1c had significantly higher uric acid levels compared to those with lower HbA1c levels, with diabetic levels of HbA1c accounting for approximately 40% of the variance in uric acid levels. Additionally, study participants who smoked cigarettes were more likely to have hyperuricemia than non-smokers.
Preventive educational efforts focused on diet and lifestyle are critical to reducing the incidence of gout and Type 2 Diabetes in low-income elderly populations. Diabetic individuals are at a higher risk of developing hyperuricemia and gout compared to non-diabetics. Community-based educational health programs are necessary to make a measurable impact on these populations, prevent disease progression, and reduce the burden on healthcare systems.
服务不足和代表性不足的人群往往难以获得负担得起的优质医疗保健、教育资源和营养食品,所有这些都会增加患2型糖尿病和痛风的风险。2型糖尿病是一种由于长期高血糖水平导致胰岛素受体变性,进而导致血糖调节受损的疾病。痛风是一种影响下肢关节的慢性炎症性疾病,其特征是血清尿酸水平升高以及尿酸晶体在滑液中积聚,导致疼痛发作,严重影响生活质量。
这项多地点横断面研究在美国中大西洋地区的三个低收入老年人居住社区进行,包括宾夕法尼亚州的费城和哈里斯堡以及马里兰州的克林顿。共有88名同意参与的参与者接受了健康史调查,并使用指尖采血测试和市售设备检测了糖化血红蛋白(HbA1c)、血糖和尿酸水平。纳入标准包括年龄在35 - 92岁、居住在这些社区的任何性别个体。排除标准为有癌症、器官移植个人史或当前怀孕。在讨论每个参与者的结果后提供了教育材料。
在这群患有2型糖尿病的低收入老年人中,痛风的患病率是可识别的。参与者中,30.7%的人血清尿酸水平表明患有高尿酸血症,超过了国家健康和营养检查调查所报告的全国平均水平20.1%。与HbA1c水平较低的参与者相比,HbA1c水平高的参与者尿酸水平显著更高,糖尿病水平的HbA1c约占尿酸水平变化的40%。此外,吸烟的研究参与者比不吸烟者更有可能患高尿酸血症。
专注于饮食和生活方式的预防性教育努力对于降低低收入老年人群中痛风和2型糖尿病的发病率至关重要。与非糖尿病患者相比,糖尿病患者患高尿酸血症和痛风的风险更高。基于社区的教育健康项目对于对这些人群产生可衡量的影响、预防疾病进展以及减轻医疗系统负担是必要的。