Susan Grandy
AstraZeneca
Network
Latest external collaboration on country level. Dive into details by clicking on the dots.
Publication
Featured researches published by Susan Grandy.
International Journal of Clinical Practice | 2007
Harold E. Bays; Richard H. Chapman; Susan Grandy
The objectives of this study were to explore the relation between body mass index (BMI) and prevalence of diabetes mellitus, hypertension and dyslipidaemia; examine BMI distributions among patients with these conditions; and compare results from two national surveys. The Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD) 2004 screening questionnaire (mailed survey) and the National Health and Nutrition Examination Surveys (NHANES) 1999–2002 (interview, clinical and laboratory data) were conducted in nationally representative samples ≥ 18 years old. Responses were received from 127,420 of 200,000 households (64%, representing 211,097 adults) for SHIELD, and 4257 participants for NHANES. Prevalence of diabetes mellitus, hypertension and dyslipidaemia was estimated within BMI categories, as was distribution of BMI levels among individuals with these diseases. Mean BMI was 27.8 kg/m2 for SHIELD and 27.9 kg/m2 for NHANES. Increased BMI was associated with increased prevalence of diabetes mellitus, hypertension and dyslipidaemia in both studies (p < 0.001). For each condition, more than 75% of patients had BMI ≥ 25 kg/m2. Estimated prevalence of diabetes mellitus and hypertension was similar in both studies, while dyslipidaemia was substantially higher in NHANES than SHIELD. In both studies, prevalence of diabetes mellitus, hypertension and dyslipidaemia occurred across all ranges of BMI, but increased with higher BMI. However, not all overweight or obese patients had these metabolic diseases and not all with these conditions were overweight or obese. Except for dyslipidaemia prevalence, SHIELD was comparable with NHANES. Consumer panel surveys may be an alternative method to collect data on the relationship of BMI and metabolic diseases.
BMC Public Health | 2007
Harold E. Bays; Debbra D. Bazata; Nathaniel G. Clark; James R. Gavin; Andrew J. Green; Sandra J. Lewis; Michael L. Reed; Walter F. Stewart; Richard H. Chapman; Kathleen M. Fox; Susan Grandy
BackgroundStudies derived from continuous national surveys have shown that the prevalence of diagnosed diabetes mellitus in the US is increasing. This study estimated the prevalence in 2004 of self-reported diagnosis of diabetes and other conditions in a community-based population, using data from the Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD).MethodsThe initial screening questionnaire was mailed in 2004 to a stratified random sample of 200,000 households in the US, to identify individuals, age ≥ 18 years of age, with diabetes or risk factors associated with diabetes. Follow-up disease impact questionnaires were then mailed to a representative, stratified random sample of individuals (n = 22,001) in each subgroup of interest (those with diabetes or different numbers of risk factors for diabetes). Estimated national prevalence of diabetes and other conditions was calculated, and compared to prevalence estimates from the National Health and Nutrition Examination Survey (NHANES) 1999–2002.ResultsResponse rates were 63.7% for the screening, and 71.8% for the follow-up baseline survey. The SHIELD screening survey found overall prevalence of self-reported diagnosis of diabetes (either type 1 or type 2) was 8.2%, with increased prevalence with increasing age and decreasing income. In logistic regression modeling, individuals were more likely to be diagnosed with type 2 diabetes if they had abdominal obesity (odds ratio [OR] = 3.50; p < 0.0001), BMI ≥28 kg/m2 (OR = 4.04; p < 0.0001), or had been diagnosed with dyslipidemia (OR = 3.95; p < 0.0001), hypertension (OR = 4.82; p < 0.0001), or with cardiovascular disease (OR = 3.38; p < 0.0001).ConclusionThe SHIELD design allowed for a very large, community-based sample with broad demographic representation of the population of interest. When comparing results from the SHIELD screening survey (self-report only) to those from NHANES 1999–2002 (self-report, clinical and laboratory evaluations), the prevalence of diabetes was similar. SHIELD allows the identification of respondents with and without a current diagnosis of the illness of interest, and potential longitudinal evaluation of risk factors for future diagnosis of that illness.
Diabetes Research and Clinical Practice | 2012
Andrew J. Green; Kathleen M. Fox; Susan Grandy
AIMS This study evaluated the rate of self-reported hypoglycemia and examined the association of hypoglycemia with quality of life and depression among adults with type 2 diabetes mellitus (T2DM). METHODS Respondents to the 2008 US Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD) survey were asked the number of times they experienced hypoglycemia in the past 4 weeks and past 12 months. Respondents also completed the short form-12 (SF-12) questionnaire and the patient health questionnaire (PHQ-9). T2DM respondents reporting at least 1 hypoglycemic episode were compared with T2DM respondents who did not report hypoglycemia in the previous 12 months. RESULTS Of 2718 T2DM respondents, 23% reported experiencing hypoglycemia in the past 12 months. Respondents reporting hypoglycemia (n=627) had significantly lower (p<0.001) SF-12 scores for both physical health (mean±SD: 37.4±12.7 versus 40.9±12.7) and mental health (50.1±11.7 versus 52.4±10.1) compared with those without hypoglycemia (n=2091). Mean PHQ-9 scores were significantly higher (p<0.001) among respondents reporting hypoglycemia (5.2±5.8), compared with respondents who did not report hypoglycemia (3.9±5.0), indicating greater depression burden. CONCLUSION Self-reported hypoglycemia was prevalent among individuals with T2DM and associated with lower health-related quality of life, and greater burden of depression.
Journal of Vascular Surgery | 2003
Karin S. Coyne; Mary Kay Margolis; Kim Gilchrist; Susan Grandy; William R. Hiatt; Andrea Ratchford; Dennis A. Revicki; William S. Weintraub; Judith G. Regensteiner
BACKGROUND Intermittent claudication resulting from peripheral arterial disease (PAD) can substantially impair walking function. The Walking Impairment Questionnaire (WIQ) assesses patient self-reported difficulty in walking. Currently this questionnaire is validated for interviewer administration only. Since this can be burdensome in a large clinical trial, we examined the effects of alternative methods of administration on patient responses on the WIQ. METHODS The WIQ, which consists of four subscales (pain severity, distance, speed, stairs), was modified to be self-administered or interviewer-administered by telephone. Patients with PAD were recruited from two sites and randomized into two groups: in group 1 the WIQ was self-administered, then telephone-administered; in group 2 the WIQ was telephone-administered, then self-administered. The two administrations occurred 4 to 7 days apart. Additional measures (SF-36, EQ-5D, and PAD symptom scale) and clinical data were included to further assess the validity of the WIQ and symptoms in patients with claudication. Telephone interviews were conducted by trained interviewers using standardized scripts. Two-week test-retest reliability was assessed for both the self-administered WIQ (group 1) and the telephone-administered WIQ (group 2). RESULTS Sixty patients were recruited at two sites (n = 30 per group). Seventy-eight percent were men; mean patient age was 67.1 years; and 83% of patients were white. Mean duration of PAD symptoms was 6.8 years. No significant differences were observed in WIQ subscale scores between self administration and telephone administration. No interaction effects between order and method of administration were detected. Cronbach alpha for distance, speed, and stair-climbing subscales ranged from 0.82 to 0.94. Correlations among WIQ subscales and the symptom scale were good (r = -0.34 to -0.57). Correlations of WIQ subscales with physical health subscales of the SF-36 (r = 0.24-0.59) were higher than for mental health-related subscales (r = 0.08-0.26). CONCLUSIONS The modified WIQ demonstrated good reliability and validity with both methods of administration. These results suggest that the self-administered and telephone-administered versions of the WIQ can be used reliably and efficiently in clinical trials.
American Journal of Health Promotion | 2009
Helena W. Rodbard; Kathleen Fox; Susan Grandy
Purpose. Evaluate work absence, work productivity, and disruption of work, social, and family life among individuals of varying body mass index (BMI) with or at risk for diabetes mellitus. Design. Cross-sectional analysis of survey data. Setting. Community-based U.S. population. Subjects. Respondents (n = 15,132; n = 7338 working adults) participating in the U.S. Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD) study were stratified by combinations of BMI (i.e., ≥ 30 kg/m2 [obese], 25 to 29.9 kg/m2 [overweight], and < 25 kg/m2 [normal weight]) and diabetes (i.e., type 2 diabetes mellitus [T2DM], type 1 diabetes mellitus [T1DM], and high risk [HR] or low risk [LR] of T2DM). Measures. Work impairment was measured using the Work Productivity and Activity Impairment Questionnaire: General Health. Disruption in life was measured using the Sheehan Disability Scale. HR was defined as 3 to 5 of the following factors: abdominal obesity, BMI ≥ 28 kg/m2, reported diagnosis of “cholesterol problems,” reported diagnosis of “hypertension,” or history of coronary heart disease or stroke. LR was defined as ≤ 2 of these factors. Results. Percentage of work impairment and proportion with severe disruption of work, family, and social life increased systematically from normal weight to obese (p < .001). Obese individuals had the greatest impairment at work (11%-15% of work time), greatest impairment of daily activities (20%-34% of time), and greatest overall impairment (11%-15% of time) in the LR, HR, and T2DM groups. Obesity and T2DM were independent predictors of overall work impairment and life disruption (p < .001). Between 5% and 7% of total variance was explained in the regression models with BMI category, diabetes/risk group, age, gender, race, income, and household size as variables. Conclusion. Greatest impairment of work and daily activities was evident among obese individuals for all groups.
Diabetes Care | 2007
Nathaniel G. Clark; Kathleen Fox; Susan Grandy
OBJECTIVE—The American Diabetes Association (ADA) lists seven symptoms of diabetes; however, it is not known how specific these symptoms are for initial diagnosis of type 2 diabetes. The Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD) examined prevalence of ADA symptoms and their association with diabetes diagnosis. RESEARCH DESIGN AND METHODS—SHIELD is a 5-year observational study of individuals with or at risk for diabetes diagnosis. Following an initial screening phase, follow-up questionnaires were mailed to a stratified random sample of individuals (n = 22,001) with type 1 or type 2 diabetes or at high (three to five risk factors) or low (zero to two risk factors) risk for diabetes. Individuals reported whether they experienced each ADA symptom, as well as symptoms unrelated to diabetes. RESULTS—A total of 15,794 questionnaires were returned (response rate 71.8%). All ADA symptoms were reported more frequently in type 2 diabetes than in low- and high-risk groups (P < 0.0001 for each). Multivariable logistic regression analyses found that each ADA symptom other than irritability was significantly associated with type 2 diabetes, as was erectile/sexual dysfunction. However, 48% of type 1 diabetic and 44% of type 2 diabetic respondents reported no ADA symptom in the previous year. CONCLUSIONS—Occurrence of ADA symptoms alone may not adequately identify those who should be evaluated for type 2 diabetes. Longitudinal data from SHIELD will evaluate whether combinations of symptoms or addition of other symptoms can better identify individuals for evaluation.
International Journal of Clinical Practice | 2008
Sandra J. Lewis; H. W. Rodbard; Kathleen M. Fox; Susan Grandy
Purpose: This study assessed awareness of metabolic syndrome and evaluated health knowledge, attitudes and behaviours of respondents at risk.
Health and Quality of Life Outcomes | 2012
Susan Grandy; Kathleen M. Fox
BackgroundHealth-related quality of life studies among adults with type 2 diabetes mellitus, using the EQ-5D, have been short term and have not assessed change over years. This study assessed the change in health status and health-related quality of life over 5 years among individuals with and without diabetes.MethodsRespondents to the US S tudy to H elp I mprove E arly evaluation and management of risk factors L eading to D iabetes (SHIELD) completed the EuroQol-5D (EQ-5D) at baseline (2004) and 5 years later (2009). Visual analog scale (VAS) score and health index score were computed at baseline and year 5, and the change over 5 years was measured for individuals with type 2 diabetes mellitus (T2DM) and those without diabetes, and T2DM adults with and without diabetic complications. Linear regression models were used to determine change in EQ-5D score, controlling for age, gender, race, education, household income, and body mass index (BMI).ResultsThere was significantly greater decline in the EQ-5D index score in the T2DM group (-0.031 [SD 0.158]), compared with those without diabetes (-0.016 [0.141], p = 0.001). Compared with respondents without diabetes, those with T2DM had a larger reduction in EQ-5D index score, after controlling for demographics (p = 0.001). EQ-5D VAS score declined over 5 years for both groups: -1.42 (18.1) for the T2DM group, and -0.63 (15.8) for the group without diabetes, but the between-group difference was not significant either before (p = 0.09) or after (p = 0.12), controlling for demographics. T2DM respondents with diabetic complications had a greater decline in EQ-5D scores than T2DM respondents without complications (p < 0.05).ConclusionOver a 5-year period, health status of respondents with T2DM declined significantly compared with those with no diabetes, indicating that the burden of the disease has a long-term detrimental impact. This decline in health status is likely to impact utility scores (fewer quality-adjusted life years) for economic evaluations.
International Journal of Clinical Practice | 2007
A. J. Green; D. D. Bazata; Kathleen M. Fox; Susan Grandy
Objectives: The study assessed knowledge, attitudes and behaviours towards health, diabetes, diet and exercise among respondents with type 2 diabetes mellitus and those with cardiometabolic risk factors.
Journal of Obesity | 2011
Andrew J. Green; Kathleen M. Fox; Susan Grandy
Objective. To examine the association between exercising regularly and trying to lose weight, and quality of life among individuals with and without type 2 diabetes mellitus (T2DM). Methods. Respondents to the US SHIELD baseline survey reported whether they had tried to lose weight during the previous 12 months and whether they exercised regularly for >6 months. Respondents completed the SF-12 quality-of-life survey one year later. Differences between T2DM respondents (n = 2419) and respondents with no diabetes (n = 6750) were tested using t-tests and linear regression models adjusting for demographics, body mass index (BMI), and diabetes status. Results. After adjustment, exercising regularly was significantly associated with higher subsequent physical and mental component scores (P < .001). After adjustment, trying to lose weight was not associated with higher physical component scores (P = .87), but was associated with higher mental component scores (P = .01). Conclusion. Respondents who reported exercising regularly had significantly better physical and mental quality of life, compared with respondents who did not exercise regularly. Despite exercising regularly, respondents with T2DM had significantly worse quality of life, compared with respondents without diabetes who exercised regularly.