Maritime Health Research and Education-NET/The International Type 2 Diabetes Mellitus and Hypertension Research Group
International Diabetes and Hypertension Research GroupEdit
The International Diabetes and Hypertension Research Group for fishers, seafarers and other transport workers was created the 12 Jan 2022 in a Zoom conference by specialists in diabetes epidemiology, diabetology, occupational epidemiology, occupational/maritime medicine and public health from Denmark, Greenland, Spain, France, Panamá. Russia and The Filippines. The aim is to provide a foundation for safe and healthy preventive strategies within the UN Global Sustainable Goals, especially Goal 3: Good health and well-being for all workers ,Goal 4: Quality education,Goal 8: Decent Work and Economic Growth and Goal 17: Partnerships to achieve the goals with the primary tasks. Millions of medical examinations are done every year for seafarers, fishers, truck drivers, loco-, bus- and taxi drivers. Most of them use the non-valid urine-sticks and no valid test for T2D, no A1c or FG. By adding biannual screening of hypertension and diabetes mellitus the target groups can be rescued from loss of workability, loss of QUALies and loss of living years. Screening for hypertension and diabetes is cost-effective and sustainable with low extra cost, possibility for no or small extra visit fee and A1C test around 20-50 USD[1] as the target group need to attend to the medical clinics for their obligatory often biannual medical examination, anyway. While the extra cost for A1c blood test, lack of laboratory access and clinical time consume might be a problem, then the strategy is to validate and replace A1C with Glukometer test[2][3][4][5][6][7]
MembersEdit
Screening program for diabetes type 2 and hypertension in seafarers’ routine medical examinationsEdit
The program combines the biannual, mandatory clinical fit-for-duty health examinations for seafarers in a Public Health perspective with biannual screening for Diabetes Type 2 and Hypertension. An improved prevention is expected by combining with the "Green-ship" health promotion program. The neglected diagnostic problem that the urine dipstick of low validity erroneously has been used for diagnosis of diabetes type 2 in the fit-for-duty medical examinations, is solved. The study adds a protocol with a ready to use Excel Data Entry scheme for the medical clinics to perform an accurate screening for diabetes mellitus type 2 and hypertension. Sustainability is obtained by having seafarers coming biannually for mandatory medical examination, anyway. With the advantages that extra costs for the screening are minimized and the participation in the screening program will be nearly 100%. Implementation of the protocol in a global perspective is expected to have significant health impact not only for seafarers, but also for other transport workers, the companies and the society. The screening program is derived from the initial two projects: "Early diagnostics of T2DM via routine medical exams" and "Early diagnostics of Hypertension via routine medical exams" It is important to record the pre-hypertension epidemiologically and for the seafarers as there is an obvious possibility of prevention. It is also important to have a plan for the prevention of the various degrees of hypertension[8]
Revision of the ILO Guidelines for medical examination for seafarersEdit
Revision of the WHO International Medical Guide for ShipsEdit
Revision of the Ships Medical ChestEdit
T2D and HTN Research and Education plan 2030Edit
Research seminarsEdit
Learning from Interventions in non-maritime workplacesEdit
Diabetes T2 and Hypertension Research and Education plan 2022-2030Edit
| International |
| Annual International Research and Education Seminars (Dec 2022) |
| Revise the International ILO Guide medical examinations for seafarers |
| Establish T2D and HTN international/national data register |
| Revision of the WHO International Medical Guide for Ships |
| Revision of the Ships Medical Chest |
| Multi faceted health promotion “Sustainable ship”guidelines |
| Knowledge and practice of what works review study |
| Strategic diferentiated education and training for the social groups |
| Education and training health promotion |
| Education program on knowledge and practice T2D & HTN |
| Development online educational- and training materials T2D and HTN |
| Implementation, evaluation and revision of online materials |
| Establish the "International Maritime Public Health School" |
| Accuracy of screening and follow-up for T2D |
| Accuracy of glucose meters for seafarers own control on board |
| Accuracy and costs of glucose meters for screening in clinics |
| Accuracy and costs of non-invasive glucose meters screening |
| Clinical applicability and cost-effectiveness of DIABSCORE |
| Accuracy of screening and follow-up for HTN |
| Epidemiology multicenters |
| Monitoring T2D and hypertension (HTN) from the Screening program |
| Loss of working years for seafarers with T2D and HTN |
| Co-morbidity for T2D and HTN (mental, CVD, feet, vision) |
| Seafarers selection out of cohort due to HTN and T2D |
| Seafarers' lack compliance with the advice and need for booster training |
| Electronic Data Capture Software: |
| Google Forms, other |
| Workplace risk factors |
| Work risk factors like stress, strain, shift-work for T2D and HTN risk |
| Workplace stigma and discrimination for T2D and HTN |
| How to continue working at sea with T2D and HTN |
| Guide to manage T2D znd HTN at the workplaces at sea |
| Best clinical practices for maritime T2D and HTN diagnostics |
| Guidelines for T2D and HTN diagnostics (A1C, FPG) |
| Program for the newly diagnosed type 2 diabetes seafarers (ILO)* |
| Best care practices for T2D/HTN seafarers at work and home |
| Non-pharm maritime intervention |
| Review of effect workplace interventions T2D HTN |
| Pharmacological and non-pharm T2D/HTN Interventions |
| Review of pharmacological intervention study effects |
| Review of combined pharm/non-pharm intervention study effects |
| Protocol for combined pharm and non-pharm intervention study effects |
| Financial costs for HTN and T2D |
| Loss of workability and compensation costs |
| Medical treatment and diagnostics cost for HTN, T2D and co-morbidities |
| Review and Guidelines to reduce inappropriate laboratory testing |
ReferencesEdit
- ↑ https://www.talktomira.com/post/what-is-a-diabetes-screening-test-and-how-much-it-costs
- ↑ Chen, Huizhen, Qingtao Yao, Yang Dong, Zhimei Tang, Ruiying Li, Baochao Cai, Ruili Wang, and Qiu Chen. “The Accuracy Evaluation of Four Blood Glucose Monitoring Systems According to ISO 15197:2003 and ISO 15197:2013 Criteria.” Primary Care Diabetes 13, no. 3 (June 2019): 252–58. https://doi.org/10.1016/j.pcd.2018.12.010
- ↑ Chubb, S. A. Paul, Kylie Van Minnen, Wendy A. Davis, David G. Bruce, and Timothy M. E. Davis. “The Relationship between Self-Monitoring of Blood Glucose Results and Glycated Haemoglobin in Type 2 Diabetes: The Fremantle Diabetes Study.” Diabetes Research and Clinical Practice 94, no. 3 (December 2011): 371–76. https://doi.org/10.1016/j.diabres.2011.07.038
- ↑ Kenning, Matthes, Anselm Puchert, Sabine Berg, and Eckhard Salzsieder. “System Accuracy of the Blood Glucose Monitoring System TD4216.” Journal of Diabetes Science and Technology 14, no. 5 (March 7, 2020): 976–77. https://doi.org/10.1177/1932296820910785.
- ↑ Makris, K., L. Spanou, A. Rambaouni-Antoneli, K. Koniari, I. Drakopoulos, D. Rizos, and A. Haliassos. “Relationship between Mean Blood Glucose and Glycated Haemoglobin in Type 2 Diabetic Patients.” Diabetic Medicine: A Journal of the British Diabetic Association 25, no. 2 (February 2008): 174–78. https://doi.org/10.1111/j.1464-5491.2007.02379.x.
- ↑ Pashintseva, L. P., V. S. Bardina, I. R. Il’iasov, B. P. Mishchenko, and M. B. Antsiferov. “[The clinical laboratory evaluation of accuracy of portable glucometers ‘Satellite Express’ and ‘Satellite Express mini’].” Klinicheskaia Laboratornaia Diagnostika, no. 11 (November 2011): 33–35.
- ↑ Sarwat, S., L. L. Ilag, M. A. Carey, D. S. Shrom, and R. J. Heine. “The Relationship between Self-Monitored Blood Glucose Values and Glycated Haemoglobin in Insulin-Treated Patients with Type 2 Diabetes.” Diabetic Medicine: A Journal of the British Diabetic Association 27, no. 5 (May 2010): 589–92. https://doi.org/10.1111/j.1464-5491.2010.02955.x.
- ↑ https://pubmed.ncbi.nlm.nih.gov/29046988/