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Articles by D. W. Dunstan
Total Records ( 3 ) for D. W. Dunstan
  R. A. Sicree , P. Z. Zimmet , D. W. Dunstan , A. J. Cameron , T. A. Welborn and J. E. Shaw
  Aim  To determine the extent of gender-related differences in the prevalence of glucose intolerance for the Australian population and whether body size may explain such differences.

Methods  Cross-sectional data were collected from a national cohort of 11 247 Australians aged ≥ 25 years. Glucose tolerance status was assessed according to both fasting plasma glucose (FPG) and 2-h plasma glucose (2hPG) levels following a 75-g oral glucose tolerance test (OGTT). Anthropometric and glycated haemoglobin measurements were also made.

Results  Undiagnosed diabetes and non-diabetic glucose abnormalities were more prevalent among men than women when based only on the FPG results (diabetes: men 2.2%, women 1.6%, P = 0.02; impaired fasting glycaemia: men 12.3%, women 6.6%, P < 0.001). In contrast 16.0% of women and 13.0% of men had a 2hPG abnormality (either diabetes or impaired glucose tolerance, P = 0.14). Women had a mean FPG 0.3 mmol/l lower than men (P < 0.001), but 2hPG 0.3 mmol/l higher (P = 0.002) and FPG-2hPG increment 0.5 mmol/l greater (P < 0.001). The gender difference in mean 2hPG and FPG-2hPG increment disappeared following adjustment for height. For both genders, those in the shortest height quartile had 2hPG levels 0.5 mmol/l higher than the tallest quartile, but height showed almost no relationship with the FPG.

Conclusions  Men and women had different glycaemic profiles; women had higher mean 2hPG levels, despite lower fasting levels. It appeared that the higher 2hPG levels for women related to lesser height and may be a consequence of using a fixed glucose load in the OGTT, irrespective of body size.

  F. Xu , Y. Wang , R. S. Ware , L. Ah Tse , D. W. Dunstan , Y. Liang , Z. Wang , X. Hong and N. Owen
  Aims  To investigate the joint influence of physical activity and family history of diabetes on the subsequent risk of developing hyperglycaemia and Type 2 diabetes among Chinese adults.

Methods  A prospective community-based cohort study was conducted among adults aged 35 years and older during 2004-2007 in Nanjing, China. Four communities (three urban and one rural) were randomly selected from 11 urban districts and two rural counties. Hyperglycaemia and Type 2 diabetes were defined using World Health Organization criteria based on fasting blood glucose concentration and physicians' diagnosis, respectively. Physical activity, parental diabetes history, and other important covariates were assessed at baseline and in the third-year follow-up survey.

Results  At study conclusion data were collected from 3031 participants (follow-up rate 81.3%). The 3-year cumulative incidence of hyperglycaemia and Type 2 diabetes was 6.2% and 2.4%, respectively. After adjustment for potential confounding variables, compared with those with positive family history and insufficient physical activity, the adjusted relative risk ratio (95% CI) of developing hyperglycaemia was 0.19 (0.02, 1.51) for participants with sufficient physical activity and a positive family history; 0.55 (0.31, 0.97) for participants with insufficient physical activity and a negative family history; and 0.36 (0.19, 0.70) for participants with sufficient physical activity but a negative family history. Participants who had a negative family history and insufficient physical activity were also less likely to develop Type 2 diabetes (RRR = 0.28; 0.14, 0.54), and participants with a negative family history and sufficient physical activity were the least likely to develop Type 2 diabetes (0.23; 0.10, 0.56).

Conclusions  Sufficient physical activity and negative family history of diabetes may jointly reduce the risk of developing hyperglycaemia and Type 2 diabetes in Chinese adults.

  A. L. S. Hansen , K. Wijndaele , N. Owen , D. J. Magliano , A. A. Thorp , J. E. Shaw and D. W. Dunstan
  Background  Television viewing time is associated cross-sectionally with abnormal glucose tolerance and diabetes risk; however, the impact of changes in television viewing time on glycaemic measures is less understood. We examined relationships of 5-year change in television viewing time with 5-year change in glucose homeostasis markers.

Methods  Participants in the Australian Diabetes, Obesity and Lifestyle study with data available at the 1999-2000 baseline and the 2004-2005 follow-up were included (4870; 45% men). Television viewing time (h/week) was assessed by questionnaire. Fasting plasma glucose, serum insulin and 2-h plasma glucose were obtained from an oral glucose tolerance test. Beta-cell function and insulin resistance were ascertained using the homeostasis model assessment 2-calculator. Associations of change in television viewing time with changes in glucose homeostasis markers were examined using linear regression models [β-coefficients (95% CI)]. Adjustments included baseline measures of age, television viewing time and glycaemic marker, and baseline and 5-year change in diet quality, energy intake, physical activity and waist circumference.

Results  For every 5-h per week increase in television viewing time from baseline to 5-year follow-up, changes in glucose homeostasis markers were observed: among women there was a significant increase in fasting plasma glucose [0.01 (0.00-0.02) mmol/l] insulin resistance [0.03 (0.01-0.05)] and insulin secretion [1.07 (0.02-2.12) %]; insulin levels increased [men: 1.20 (0.30-2.09); women: 1.06 (0.32-1.80) pmol/l]; in men, 2-h plasma glucose levels increased [0.06 (0.01-0.1) mmol/l].

Conclusion  Five-year increases in television viewing time were associated adversely with changes in glucose homeostasis markers. These findings add to earlier cross-sectional evidence that television viewing time can be associated with biomarkers of diabetes risk.

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