The influence of pre-existing health conditions on short-term mortality risks of temperature: Evidence from a prospective Chinese elderly cohort in Hong Kong

Abstract

Elders with pre-existing health conditions were more vulnerable to excess mortality risk to hot and/or cold temperature. Preventative measures should target on elders with chronic health problems.

How Does Ambient Air Temperature Affect Diabetes Mortality in Tropical Cities?

“…At lag slice 7, in lag 0–15 as in Figure 1, most of the cities have greater risks in both the extreme and moderate low temperature percentiles. These results are similar to the studies in China [17,18,19]. The physiological mechanism of the increased risk of low temperatures on diabetes remains unclear.…”

“…In this study, we have observed that the effects of temperature on diabetes are higher in extreme temperatures as seen in Table 2, which are consistent with literature [23,25,27]. The mechanism related to the increased risk in high temperatures among diabetics can be linked to the abnormalities of the thermoregulatory capacity caused by autonomic neuropathy [17,18,37]. Autonomic neuropathy is a potentially lethal diabetic complication, which affects multiple organ systems and of different clinical manifestations, with severe consequences such as hypoglycemia unawareness and cardiovascular dysfunction [38,39,40,41].…”

“…Low and high temperatures were classified into four categories with respect to the reference temperature percentile: extreme low (25th temperature percentile vis-à-vis 1st temperature percentile), moderate low (25th temperature percentile vis-à-vis 10th temperature percentile), moderate high (75th temperature percentile vis-à-vis 90th temperature percentile), and extreme high (75th temperature percentile vis-à-vis 99th temperature percentile) [17,18]. We varied the maximum lags at 2, 7, 15 and 21 days to observe both the immediate and prolonged temperature effects on diabetes mortality [17].…”

“…Previous studies have shown that the association of temperature and diabetes mortality is nonlinear [17,18,19]. In order to address this nonlinearity, we used a distributed lag non-linear model (DLNM) to account for both the non-linear and delayed effects of temperature on diabetes mortality with a quasi-Poisson link to account for over-dispersion [9,31].…”

“…Heat impairs both the thermoregulative and orthostatic responses at high temperatures, while apparent loss of efferent vasomotor control during diabetic neuropathy have been noted in cold periods [15,16]. However, most studies that explored the effects of temperature on diabetes mortality were mainly undertaken in temperate and subtropical cities [17,18,19,20,21,22,23,24,25,26,27]; to the best of our knowledge, no study has been carried out in a tropical setting. This is the first study which explored the effects of temperature on diabetes mortality in a multi-city tropical setting.…”