Papers by Catherine Cowie
Diabetes/Metabolism Research and Reviews, 2002
Background Fasting serum insulin and fasting serum C-peptide are risk factors for developing type... more Background Fasting serum insulin and fasting serum C-peptide are risk factors for developing type 2 diabetes. Because of the higher incidence of type 2 diabetes in African Americans and Hispanic Americans, it is likely that these groups may differ from non-Hispanic whites in their levels of insulin and C-peptide.
Diabetes/Metabolism Research and Reviews, 2002
Background Fasting serum insulin and fasting serum C-peptide are risk factors for developing type... more Background Fasting serum insulin and fasting serum C-peptide are risk factors for developing type 2 diabetes. Because of the higher incidence of type 2 diabetes in African Americans and Hispanic Americans, it is likely that these groups may differ from non-Hispanic whites in their levels of insulin and C-peptide.
Diabetes/Metabolism Research and Reviews, 2002
Background Fasting serum insulin and fasting serum C-peptide are risk factors for developing type... more Background Fasting serum insulin and fasting serum C-peptide are risk factors for developing type 2 diabetes. Because of the higher incidence of type 2 diabetes in African Americans and Hispanic Americans, it is likely that these groups may differ from non-Hispanic whites in their levels of insulin and C-peptide.
Metals in Urine and Diabetes in United States Adults
Diabetes, Jan 5, 2015
Our objective was to evaluate the relationship of urine metals including barium, cadmium, cobalt,... more Our objective was to evaluate the relationship of urine metals including barium, cadmium, cobalt, cesium, molybdenum, lead, antimony, thallium, tungsten, and uranium with diabetes prevalence. Data were from a cross-sectional study of 9447 participants of the 1999-2010 National Health and Nutrition Examination Survey, a representative sample of the US civilian non-institutionalized population. Metals were measured in a spot urine sample and diabetes status was determined based on a previous diagnosis or an A1c ≥6.5% (48 mmol/mol). After multivariable adjustment, the odds ratios (95% confidence interval) of diabetes associated with the highest quartile of metal, compared to the lowest quartile, were 0.86 (0.66-1.12) for barium (p-trend=0.13), 0.74 (0.51-1.09) for cadmium (p-trend=0.35), 1.21 (0.85-1.72) for cobalt (p-trend=0.59), 1.31 (0.90-1.91) for cesium (p-trend=0.29), 1.76 (1.24-2.50) for molybdenum (p-trend=0.01), 0.79 (0.56-1.13) for lead (p-trend=0.10), 1.72 (1.27-2.33) for an...
Prevalence of and Trends in Diabetes Among Adults in the United States, 1988-2012
JAMA, Jan 8, 2015
Previous studies have shown increasing prevalence of diabetes in the United States. New US data a... more Previous studies have shown increasing prevalence of diabetes in the United States. New US data are available to estimate prevalence of and trends in diabetes. To estimate the recent prevalence and update US trends in total diabetes, diagnosed diabetes, and undiagnosed diabetes using National Health and Nutrition Examination Survey (NHANES) data. Cross-sectional surveys conducted between 1988-1994 and 1999-2012 of nationally representative samples of the civilian, noninstitutionalized US population; 2781 adults from 2011-2012 were used to estimate recent prevalence and an additional 23,634 adults from 1988-2010 were used to estimate trends. The prevalence of diabetes was defined using a previous diagnosis of diabetes or, if diabetes was not previously diagnosed, by (1) a hemoglobin A1c level of 6.5% or greater or a fasting plasma glucose (FPG) level of 126 mg/dL or greater (hemoglobin A1c or FPG definition) or (2) additionally including 2-hour plasma glucose (2-hour PG) level of 200...
Stakeholder opinions on the practicality of management interventions to control bovine tuberculosis
Veterinary journal (London, England : 1997), 2015
Livestock disease control strategies are usually determined at national and international levels,... more Livestock disease control strategies are usually determined at national and international levels, yet their successful implementation is determined by stakeholders operating at local scales. Such stakeholders may also have detailed knowledge that would contribute to the development of disease control options suited to the socio-cultural and environmental conditions where management is undertaken. The aim of this study was to evaluate stakeholders' opinions of a list of potential bovine tuberculosis (TB) management interventions for South Central Spain. This area has high TB prevalence in wildlife and livestock, so veterinarians, livestock farmers and hunters are all key stakeholders in TB management. A literature review identified possible management activities. The effectiveness of each intervention was ranked by local experts, and practicality was ranked by hunters, cattle farmers and veterinarians, using a best-worst scaling exercise as part of a questionnaire. The most effec...
Delayed Gastric Emptying is Associated with Early and Long-Term Hyperglycemia in Type 1 Diabetes Mellitus
Gastroenterology, 2015
After the Diabetes Control and Complications Trial (DCCT), the Epidemiology of Diabetes Intervent... more After the Diabetes Control and Complications Trial (DCCT), the Epidemiology of Diabetes Interventions and Complications (EDIC) study continued to demonstrate persistent benefit of prior intensive therapy on neuropathy, retinopathy, and nephropathy in type 1 diabetes mellitus (DM)., The relationship between control of glycemia and gastric emptying (GE) is unclear. We assessed GE with a (13)C-spirulina breath test and symptoms in 78 participants with type 1 diabetes at year 20 of EDIC. The relationship between delayed GE and HbA1c, complications of DM, and gastrointestinal symptoms were evaluated. GE was normal (37 participants, 50%), delayed (35 participants, 47%), or rapid (2 participants, 3%). The latest mean HbA1c was 7.7%. In univariate analyses, delayed GE was associated with greater DCCT baseline HbA1c and duration of DM prior to DCCT (P ≤ 0.04), greater mean HbA1c over an average of 27 years of follow up (during DCCT-EDIC, P = 0.01), lower R-R variability during deep breathing (P=0.03) and severe nephropathy (P=0.05) and a greater composite upper gastrointestinal symptom score (P<0.05). In multivariate models, retinopathy was the only complication of DM associated with delayed GE. Separately, DCCT baseline HbA1c (OR 1.6, 95% CI 1.1-2.3) and duration of DM (OR 1.2, 95%CI 1.01-1.3) prior to DCCT entry and mean HbA1c during DCCT-EDIC (OR 2.2, 95%CI 1.04-4.5) were independently associated with delayed GE. In the DCCT/EDIC study, delayed GE was remarkably common and associated with gastrointestinal symptoms and with measures of early and long-term hyperglycemia. ClinicalTrials.gov numbers NCT00360815 and NCT00360893.
Receipt of Glucose Testing and Performance of Two US Diabetes Screening Guidelines, 2007–2012
PLOS ONE, 2015
Screening guidelines are used to help identify prediabetes and diabetes before implementing evide... more Screening guidelines are used to help identify prediabetes and diabetes before implementing evidence-based prevention and treatment interventions. We examined screening practices benchmarking against two US guidelines, and the capacity of each guideline to identify dysglycemia. Using 2007-2012 National Health and Nutrition Examination Surveys, we analyzed nationally-representative, cross-sectional data from 5,813 fasting non-pregnant adults aged ≥20 years without self-reported diabetes. We examined proportions of adults eligible for diagnostic glucose testing and those who self-reported receiving testing in the past three years, as recommended by the American Diabetes Association (ADA) and the US Preventive Services Task Force (USPSTF-2008) guidelines. For each screening guideline, we also assessed sensitivity, specificity, and positive (PPV) and negative predictive values in identifying dysglycemia (defined as fasting plasma glucose ≥100 mg/dl or hemoglobin A1c ≥5.7%). In 2007-2012, 73.0% and 23.7% of US adults without diagnosed diabetes met ADA and USPSTF-2008 criteria for screening, respectively; and 91.5% had at least one major risk factor for diabetes. Of those ADA- or USPSTF-eligible adults, about 51% reported being tested within the past three years. Eligible individuals not tested were more likely to be lower educated, poorer, uninsured, or have no usual place of care compared to tested eligible adults. Among adults with ≥1 major risk factor, 45.7% reported being tested, and dysglycemia yields (i.e., PPV) ranged from 45.8% (high-risk ethnicity) to 72.6% (self-reported prediabetes). ADA criteria and having any risk factor were more sensitive than the USPSTF-2008 guideline (88.8-97.7% vs. 31.0%) but less specific (13.5-39.7% vs. 82.1%) in recommending glucose testing, resulting in lower PPVs (47.7-54.4% vs. 58.4%). Diverging recommendations and variable performance of different guidelines may be impeding national diabetes prevention and treatment efforts. Efforts to align screening recommendations may result in earlier identification of adults at high risk for prediabetes and diabetes.
Research in veterinary science, 2014
Livestock diseases can result in reduced farm productivity. The bacterial diseases tuberculosis (... more Livestock diseases can result in reduced farm productivity. The bacterial diseases tuberculosis (TB) and brucellosis may share some transmission characteristics which, if managed in common, would result in more cost-effective management. Here, we identify risk factors shared between these diseases using a case-control approach and information theoretic modelling. One-hundred cattle farmers in Atlantic Spain were interviewed about farm characteristics and management practices. The risk factor shared between both diseases was intra- and inter-herd contact between cattle. Disease-specific risk factors were the presence of wildlife for TB, and cattle movement between farms for brucellosis. An integrated approach to disease management needs to consider cattle movement and farm biosecurity, reinforced by an education campaign to increase farmer awareness. This would be likely to bring benefits in reducing both diseases and improve the efficiency of any interventions.
Diabetes Research and Clinical Practice, 2014
Previous studies have found a positive association between psoriasis and diabetes/diabetes-relate... more Previous studies have found a positive association between psoriasis and diabetes/diabetes-related complications, but the association has not been studied in a nationally representative U.S. sample. Our analysis of NHANES data indicated that psoriasis was not associated with diabetes but was positively associated with hypertension, overweight/obesity and waist circumference.
Prevalence of diabetes among Hispanics/Latinos from diverse backgrounds: the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)
Diabetes care, 2014
We examine differences in prevalence of diabetes and rates of awareness and control among adults ... more We examine differences in prevalence of diabetes and rates of awareness and control among adults from diverse Hispanic/Latino backgrounds in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). The HCHS/SOL, a prospective, multicenter, population-based study, enrolled from four U.S. metropolitan areas from 2008 to 2011 16,415 18-74-year-old people of Hispanic/Latino descent. Diabetes was defined by either fasting plasma glucose, impaired glucose tolerance 2 h after a glucose load, glycosylated hemoglobin (A1C), or documented use of hypoglycemic agents (scanned medications). Diabetes prevalence varied from 10.2% in South Americans and 13.4% in Cubans to 17.7% in Central Americans, 18.0% in Dominicans and Puerto Ricans, and 18.3% in Mexicans (P < 0.0001). Prevalence related positively to age (P < 0.0001), BMI (P < 0.0001), and years living in the U.S. (P = 0.0010) but was negatively related to education (P = 0.0005) and household income (P = 0.0043). Rate of diabe...
Diabetes care, 2014
Approximately one-third of the adult U.S. population has the metabolic syndrome. Its prevalence i... more Approximately one-third of the adult U.S. population has the metabolic syndrome. Its prevalence is the highest among Hispanic adults, but variation by Hispanic/Latino background is unknown. Our objective was to quantify the prevalence of the metabolic syndrome among men and women 18-74 years of age of diverse Hispanic/Latino background. Two-stage area probability sample of households in four U.S. locales, yielding 16,319 adults (52% women) who self-identified as Cuban, Dominican, Mexican, Puerto Rican, Central American, or South American. The metabolic syndrome was defined according to the American Heart Association/National Heart, Lung, and Blood Institute 2009 Joint Scientific Statement. The main outcome measures were age-standardized prevalence of the metabolic syndrome per the harmonized American Heart Association/National Heart, Lung, and Blood Institute definition and its component abnormalities. The metabolic syndrome was present in 36% of women and 34% of men. Differences in...
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Papers by Catherine Cowie