# Maritime Health Research and Education-NET/Diabetes 2

->DM2

# Prevalence of Diabetes 2 in seafarers in Health Metrics, Inc. Philipines.
#### Background:

The prevalence of diabetes2 is globally increasing and especially increasing with social inequality in health in relation to work and living conditions. There is a significant underreporting, so the true prevalence is not known. As part of the MAHRE-Net research program, seafarers and fishermen are seen as workers with different levels of inequality of health and justify this research project. The intention is to utilize the one- or two-year mandatory health examinations in seafarers and fishermen to do testing for Diabetes 2 with Hb1Ac strategically selected samples of employees in these occupations in different countries. The program starts in Spain with a descriptive study of the target group's prevalence of Diabetes2 from the 16th of June to 31th of December 2021 in Tarragona and Barcelona. Later the intervention will be proposed inspired by what is already done in the countries. The study is done in collaboration with the DASAM Danish Society of Occupational and Environmental Medicine, DSMM Danish Society of Maritime Medicine, SEMM, and SFMM. The Danish part is also directed at the train- and bus drivers who also have obligated biannual health examinations.

#### Purpose

To measure the Hb1Ac prevalence in the target groups in this first step of the program. Early diagnosis and prevention of diabetes2 among employees in some jobs with mandatory health examinations. To use the mandatory health examinations to include valid tests for diabetes2, i.a. with a blood test to measure Hb1Ac. To use valid methods for diagnosis, prevention, and follow-up of the effect of interventions. The prevention includes i.a. arranging the organization of the work routines, and the workplaces so that employees with Diabetes2 can continue their employment with due consideration keeping their Diabetes2 in well-treated status.

#### Goals

Systematization of the results of the mandatory health examinations for different job groups, And to make a central record of data from these health data from ther surveys for research.

#### Study design

Cross-sectional study using data collected in the maritime health clinics

#### Time frame for data collection

Data are collected in the last half year of 2021, data collection stops with 200 participants in each clinic.

#### Inclusion criteria

All seafarers and fishermen, age ≥21 years with at least 3 years of paid work in merchant seafaring or commercial fishing coming to health examinations are included. Participants are invited randomly irrespective of risk status, for example we don't invite only those with visible risk status for example those with obesity.

#### Demographics

Age, gender, seafarer, fisherman, nationality

#### Laboratory data

HbA1c, height in cm and weight in kg

#### Diagnosis

One test Hb1Ac ≥ 6,5% or a Fasting Plasma Glucose (FPG) ≥ 126 mg/dl is sufficient to confirm the diabetes diagnosis. American Diabetes Association lt
* Fasting Plasma Glucose (FPG)
* Normal less than 100 mg/dl
* Prediabetes 100 mg/dl to 125 mg/dl
* Diabetes 126 mg/dl or higher
American Diabetes Association

#### Data collection

Data from the medical- and laboratory records are entered into copies of the form below.
Personal Prevention
Simple lifestyle measures have been shown to be effective in preventing or delaying the onset of type 2 diabetes. To help prevent type 2 diabetes and its complications, people should:
* Achieve and maintain healthy body weight
* Physically active – doing at least 30 minutes of regular, moderate-intensity activity on most days. More activity is required for weight control
* Eat a healthy diet, avoiding sugar and saturated fats; and
* Avoid tobacco use – smoking increases the risk of diabetes and cardiovascular disease One test, HbA1c is sufficient to diagnose diabetes. A positive diagnosis can be made if the HbA1c level is ≥6.5% A case of positive diagnosis should be confirmed with a repeat HbA1c test and/or plasma glucose A case of positive diagnosis should be confirmed with a repeat HbA1c test and/or plasma glucose American Diabetes Association Danish Endocrinological Society

#### Intervention in collaboration with the shareholders

The shareholders in the respective job groups are included to help to establish the needed specific conditions available for keeping good health practices for employees with Diabetes 2 in the different job types. This is in order to have good opportunities during the working day to have time and allowance for relevant work breaks, restroom visits, access to healthy meals in a good social company, and possibilities for adequate physical activities. These conditions are different for each job group and the analysis of these conditions and suggestions on how it can be made optimal is part of the project. Installations for the adequate structural change in the workplaces, time for meal breaks and restroom visits, cooks are hired to make healthy lunches, fitness room, and other relevant installations.

#### Ethics for protection of personal data

Confidentiality in the handling of personal data is in accordance with the rules of the national data protection agencies and the General Data Protection Regulation (GDPR) and is prepared with. No personally sensitive information is included in the data set given to the researchers, so approval from the Ethics Committee is not necessary. All questionnaires ask for informed consent as the first question.
Data Registration Form 2021-2022 :
| MAHRE-Net Diabetes Prevalence study start date _______. finish n = 200 ||||||||||||
| Health Metrics Inc. Philippines. FORM No : ______ ||||||||||||
| To estimate the real prevalence we invite at random all, regardless of their risk, such as obesity....................... ||||||||||||
| | Example | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
| Date | 12 sep | | | | | | | | | | |
| Informed Consent (1) | X | | | | | | | | | | |
| Age | 22 | | | | | | | | | | |
| Gender m/f | m | | | | | | | | | | |
| Nationality (Philippines = 1, Other = 2) | 1 | | | | | | | | | | |
| Seafarers | X | | | | | | | | | | |
| Other | | | | | | | | | | | |
| Years of work experience | 10 | | | | | | | | | | |
| HbA1c | 5.1 | | | | | | | | | | |
| Fasting Plasma Glucose (FPG) | | | | | | | | | | | |
| Height cm | 175 | | | | | | | | | | |
| Weight kg | 75 | | | | | | | | | | |
| Comment | | | | | | | | | | | |
| (1) Ask the seafarer/fisherman if we can use anonyme data for research ||||||||||||
| Comment participant no. | | | | | | | | | | | |
| Comment participant no. | | | | | | | | | | | |

#### References

* ↑ Mata-Cases, Manel; Mauricio, Dídac; Real, Jordi; Bolíbar, Bonaventura; Franch-Nadal, Josep (2016-11-01). "Is diabetes mellitus correctly registered and classified in primary care? A population-based study in Catalonia, Spain". Endocrinología y Nutrición (English Edition) 63 (9): 440–448. doi:10.1016/j.endoen.2016.10.005. ISSN 2173-5093. https://www.elsevier.es/en-revista-endocrinologia-nutricion-english-edition--412-articulo-is-diabetes-mellitus-correctly-registered-S2173509316300952.