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Combinations of beta cell specific autoantibodies at diagnosis of diabetes in young adults reflects different courses of beta cell damage.

https://arctichealth.org/en/permalink/ahliterature47740
Source
Autoimmunity. 2001;33(2):115-20
Publication Type
Article
Date
2001
Author
C. Törn
M. Landin-Olsson
A. Lernmark
B. Scherstén
J. Ostman
H J Arnqvist
E. Björk
G. Blohmé
J. Bolinder
J. Eriksson
B. Littorin
L. Nyström
G. Sundkvist
Author Affiliation
Department of Medicine, University Hospital, Lund, Sweden. Carina.Torn@med.lu.sse
Source
Autoimmunity. 2001;33(2):115-20
Date
2001
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Autoantibodies - analysis - blood
Autoantigens - immunology
Biological Markers - blood
C-Peptide - blood
Comparative Study
Diabetes Mellitus - diagnosis - epidemiology - immunology - pathology
Follow-Up Studies
Humans
Islets of Langerhans - immunology - pathology
Membrane Proteins - immunology
Prospective Studies
Protein-Tyrosine-Phosphatase - immunology
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Sweden - epidemiology
Abstract
To explore the natural course of beta cell function in recent onset diabetes, a subgroup (n=157) of all incident cases (n=879) 15-34 years old, 1992-1993 in Sweden, and with positivity for at least one autoantibody of islet cell antibodies (ICA), glutamic acid decarboxylase antibodies (GADA) or tyrosine phosphatase antibodies (IA-2A) were followed prospectively for the first four years with annual analysis of C-peptide. The aim was to relate the course of beta cell function, measured as C-peptide, in early diabetes with the presence of different islet autoantibodies at diagnosis. We found that patients positive for ICA alone (n=11) had significantly higher C-peptide levels both at diagnosis and during the first three years compared with the other patients (n=146; p=0.022, p
PubMed ID
11264790 View in PubMed
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Direct medical costs for patients with type 2 diabetes in Sweden.

https://arctichealth.org/en/permalink/ahliterature47785
Source
J Intern Med. 2000 Nov;248(5):387-96
Publication Type
Article
Date
Nov-2000
Author
F. Henriksson
C D Agardh
C. Berne
J. Bolinder
F. Lönnqvist
P. Stenström
C G Ostenson
B. Jönsson
Author Affiliation
Centre for Health Economics, Stockholm School of Economics, Stockholm, Sweden. hefh@hhs.se
Source
J Intern Med. 2000 Nov;248(5):387-96
Date
Nov-2000
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cost of Illness
Cross-Sectional Studies
Diabetes Mellitus, Type 2 - economics - therapy
Direct Service Costs
Female
Hospitalization - economics
Humans
Male
Middle Aged
Research Support, Non-U.S. Gov't
Sweden
Abstract
OBJECTIVES: To estimate the total direct medical costs to society for patients with type 2 diabetes in Sweden and to investigate how different factors, for example diabetic late complications, affect costs. DESIGN: Cross-sectional data regarding health care utilization, clinical characteristics and quality of life, were collected at a single time-point. Data on resource use cover the 6-month period prior to this time point. SETTING: Patient recruitment and data collection were performed in nine primary care centres in three main regions in Sweden. SUBJECTS: Only patients with an age at diabetes diagnosis >/= 30 years (type 2 diabetes) were included (n = 777). RESULTS: The total annual direct medical costs for the Swedish diabetes type 2 population were estimated at about 7 billion SEK (Swedish Kronor) in 1998 prices, which is about 6% of the total health care expenditures and more than four times higher than the former Swedish estimate obtained when using diabetes as main diagnosis for calculating costs. The annual per patient cost was about 25 000 SEK. The largest share of this cost was hospital inpatient care. Costs increased with diabetes duration and were higher for patients treated with insulin compared to those treated with oral hypoglycaemic drugs or with life style modification only. Patients with both macro- and microvascular complications had more than three times higher costs compared with patients without such complications. CONCLUSIONS: Type 2 diabetes is a serious and expensive disease and the key to reducing costs seems to be intensive management and control in order to prevent and delay the associated late complications.
Notes
Comment In: J Intern Med. 2001 May;249(5):391-311350563
PubMed ID
11123503 View in PubMed
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Evaluation of the new ADA and WHO criteria for classification of diabetes mellitus in young adult people (15-34 yrs) in the Diabetes Incidence Study in Sweden (DISS).

https://arctichealth.org/en/permalink/ahliterature47416
Source
Diabetologia. 2003 Feb;46(2):173-81
Publication Type
Article
Date
Feb-2003
Author
H. Borg
H J Arnqvist
E. Björk
J. Bolinder
J W Eriksson
L. Nyström
J-O Jeppsson
G. Sundkvist
Author Affiliation
Department of Endocrinology, Wallenberg Laboratory, Entrance 46 2nd Floor, Malmö University Hospital, 205-02 Malmö, Sweden. Henrik.Borg@endo.mas.lu.se
Source
Diabetologia. 2003 Feb;46(2):173-81
Date
Feb-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Autoantibodies - analysis
C-Peptide - blood
Diabetes Mellitus - classification - epidemiology - immunology - physiopathology
Diabetes Mellitus, Type 1 - blood - immunology
Diabetes Mellitus, Type 2 - blood - immunology
Fasting - blood
Humans
Incidence
Islets of Langerhans - physiopathology
Research Support, Non-U.S. Gov't
Societies, Medical
Sweden - epidemiology
United States
World Health Organization
Abstract
AIMS/HYPOTHESIS: We aimed to evaluate how an aetiology-based classification, as recommended in the ADA and WHO guidelines for classification of diabetes mellitus, matches clinical judgement in the Diabetes Incidence Study in Sweden (DISS), a study covering incident cases of diabetic patients aged 15 to 34 years. METHODS: During a 1-year period (1998), blood samples were taken at diagnosis and 4 months (median) thereafter. Patients were classified according to clinical judgement by the reporting physicians and assessments of islet antibodies (ICA, GADA, and IA-2A) and plasma C-peptide. RESULTS: In 1998, 422 patients were registered in DISS. Among the 313 patients participating in the follow-up, most with clinical Type 1 diabetes (185/218, 85%, 95% CI 79-89%) were islet antibody positive (ab+) at diagnosis. In addition, 14 out of 58 (24%, 14-37%) with clinical Type 2 diabetes and 21 out of 37 (57%, 40-73%) with unclassifiable diabetes were antibody positive at diagnosis. Further to this, 4 out of 33 (12%, 3-28%) were antibody negative with clinical Type 1 diabetes and 4 out of 44 (9%, 3-22%) with Type 2 had converted to antibody positive at follow-up. Among those who were constantly antibody negative, 10 out of 29 (34%, 18-54%) with clinical Type 1 and 1 out of 16 (6%, 0-30%) with unclassifiable diabetes had fasting plasma C-peptide concentrations below the normal range (
Notes
Erratum In: Diabetologia. 2004 Jan;47(1):154
PubMed ID
12627315 View in PubMed
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Excess mortality in incident cases of diabetes mellitus aged 15 to 34 years at diagnosis: a population-based study (DISS) in Sweden.

https://arctichealth.org/en/permalink/ahliterature46937
Source
Diabetologia. 2006 Apr;49(4):653-9
Publication Type
Article
Date
Apr-2006
Author
I. Waernbaum
G. Blohmé
J. Ostman
G. Sundkvist
J W Eriksson
H J Arnqvist
J. Bolinder
L. Nyström
Author Affiliation
Department of Public Health and Clinical Medicine, Division of Epidemiology and Public Health Sciences, Umeå University, Umeå, Sweden.
Source
Diabetologia. 2006 Apr;49(4):653-9
Date
Apr-2006
Language
English
Publication Type
Article
Abstract
AIMS/HYPOTHESIS: The objective of the study was to analyse the mortality, survival and cause of death patterns in incident cases of diabetes in the 15-34-year age group that were reported to the nationwide prospective Diabetes Incidence Study in Sweden (DISS). MATERIALS AND METHODS: During the study period 1983-1999, 6,771 incident cases were reported. Identification of deaths was made by linking the records to the nationwide Cause of Death Register. RESULTS: With an average follow-up of 8.5 years, resulting in 59,231 person-years, 159 deaths were identified. Diabetes was reported as the underlying cause of death in 51 patients (32%), and as a contributing cause of death in another 42 patients (26%). The standardised mortality ratio (SMR) was significantly elevated (RR=2.4; 95% CI: 2.0-2.8). The SMR was higher for patients classified by the reporting physician as having type 2 diabetes at diagnosis than for those classified as type 1 diabetic (2.9 and 1.8, respectively). Survival analysis showed significant differences in survival curves between males and females (p=0.0003) as well as between cases with different types of diabetes (p=0.005). This pattern was also reflected in the Cox regression model showing significantly increased hazard for males vs females (p=0.0002), and for type 2 vs type 1 (p=0.015) when controlling for age. CONCLUSIONS/INTERPRETATION: This study shows a two-fold excess mortality in patients with type 1 diabetes and a three-fold excess mortality in patients with type 2 diabetes. Thus, despite advances in treatment, diabetes still carries an increased mortality in young adults, even in a country with a good economic and educational patient status and easy access to health care.
PubMed ID
16447054 View in PubMed
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Experience with single pancreatic transplantation in preuremic diabetic recipients in Stockholm.

https://arctichealth.org/en/permalink/ahliterature48594
Source
Transplant Proc. 1992 Jun;24(3):852-3
Publication Type
Article
Date
Jun-1992

Family characteristics and life events before the onset of autoimmune type 1 diabetes in young adults: a nationwide study.

https://arctichealth.org/en/permalink/ahliterature47716
Source
Diabetes Care. 2001 Jun;24(6):1033-7
Publication Type
Article
Date
Jun-2001
Author
B. Littorin
G. Sundkvist
L. Nyström
A. Carlson
M. Landin-Olsson
J. Ostman
H J Arnqvist
E. Björk
G. Blohmé
J. Bolinder
J W Eriksson
B. Scherstén
L. Wibell
Author Affiliation
Derpartment of Community Health Sciences, Södervärn Primary Health Care Center, Malmö University Hospital, Ahlmansgatan 12, S-214 27 Malmö, Sweden. bengt.littorin@skane.se
Source
Diabetes Care. 2001 Jun;24(6):1033-7
Date
Jun-2001
Language
English
Publication Type
Article
Keywords
Adult
Autoantibodies - blood
Case-Control Studies
Diabetes Mellitus, Type 1 - epidemiology - genetics - psychology
Educational Status
Emigration and Immigration
Family Characteristics
Female
Glutamate Decarboxylase - immunology
Humans
Islets of Langerhans - immunology
Isoenzymes - immunology
Life Change Events
Male
Maternal Age
Nuclear Family
Paternal Age
Prediabetic State - epidemiology - psychology
Questionnaires
Registries
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Sweden - epidemiology
Abstract
OBJECTIVE--To elucidate whether family characteristics and stressful life events were associated with onset of autoimmune type 1 diabetes in young adults. RESEARCH DESIGN AND METHODS--This investigation was based on a nationwide study (Diabetes Incidence Study in Sweden) of newly diagnosed patients aged 15-34 years. Patients clinically classified as type 1 diabetic with antibodies to islet cells and/or to GAD65 were compared with age- and sex-matched control subjects via questionnaire. The questionnaire covered diabetes heredity, social environment, educational level, and life events experienced during the 12 months before diagnosis. RESULTS--The rate of response was 82% for the diabetic patients and 65% for the control subjects. Questionnaires from 349 diabetic patients and 979 control subjects were considered. Diabetes in relatives was more frequent in the patients (odds ratio [OR]2.6) who were born in Sweden and whose mothers were of Swedish origin. No major stress factors were detected in the diabetic patients; however, in comparison with the control subjects, the diabetic patients had experienced fewer conflicts with their parents and had less often broken contacts with friends. CONCLUSIONS--Young adults with recent-onset type 1 diabetes were more exposed to heredity for diabetes, but no major prediabetic stress factors were detected. Our study does not directly support the concept that psychosocial stressful life events are involved in the development of autoimmune type 1 diabetes in young adults.
PubMed ID
11375366 View in PubMed
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Fear of hypoglycaemia in adults with Type 1 diabetes.

https://arctichealth.org/en/permalink/ahliterature140665
Source
Diabet Med. 2010 Oct;27(10):1151-8
Publication Type
Article
Date
Oct-2010
Author
T. Anderbro
S. Amsberg
U. Adamson
J. Bolinder
P-E Lins
R. Wredling
E. Moberg
J. Lisspers
U-B Johansson
Author Affiliation
Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Medicine, Stockholm, Sweden. therese.anderbro@ki.se
Source
Diabet Med. 2010 Oct;27(10):1151-8
Date
Oct-2010
Language
English
Publication Type
Article
Keywords
Adult
Data Collection
Diabetes Mellitus, Type 1 - drug therapy - epidemiology - psychology
Fear - psychology
Female
Humans
Hypoglycemia - drug therapy - epidemiology - psychology
Hypoglycemic agents - therapeutic use
Male
Questionnaires
Sex Distribution
Sweden - epidemiology
Abstract
The aim of this study was to examine the fear of hypoglycaemia and its association with demographic and disease-specific variables in a large and unselective population of adult patients with Type 1 diabetes.
Questionnaires were sent by post to all patients with Type 1 diabetes who were identified in the local diabetes registries of two hospitals in Stockholm, Sweden (n=1387). Fear of hypoglycaemia was measured using the Swedish Hypoglycaemia Fear Survey, the Worry subscale and the Aloneness subscale. Demographic variables and disease-specific factors were collected from patients' self reports and medical records. Univariate analysis and multiple stepwise linear regression analysis were used in the statistical analyses of the data.
Seven hundred and sixty-four (55%) patients participated in the study (mean age 43.3 years and mean HbA(1c) 7.0%, normal
PubMed ID
20854383 View in PubMed
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Glutamic acid decarboxylase antibodies (GADA) is the most important factor for prediction of insulin therapy within 3 years in young adult diabetic patients not classified as Type 1 diabetes on clinical grounds.

https://arctichealth.org/en/permalink/ahliterature47788
Source
Diabetes Metab Res Rev. 2000 Nov-Dec;16(6):442-47
Publication Type
Article
Author
C. Törn
M. Landin-Olsson
J. Ostman
B. Scherstén
H. Arnqvist
G. Blohmé
E. Björk
J. Bolinder
J. Eriksson
B. Littorin
L. Nyström
G. Sundkvist
A. Lernmark
Author Affiliation
Department of Medicine, University Hospital, Lund, Sweden. Carina.Torn@med.lu.se
Source
Diabetes Metab Res Rev. 2000 Nov-Dec;16(6):442-47
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Autoantibodies - blood
Body mass index
C-Peptide - blood
Diabetes Mellitus, Type 1 - blood - classification - drug therapy
Diabetes Mellitus, Type 2 - blood - classification - drug therapy
Diagnosis, Differential
Glutamate Decarboxylase - immunology
Humans
Hypoglycemic agents - therapeutic use
Insulin - therapeutic use
Islets of Langerhans - immunology
Isoenzymes - immunology
Predictive value of tests
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Sweden
Abstract
BACKGROUND: Differentiation between Type 1 and Type 2 diabetes in adults is difficult at diagnosis. In this study we tested the hypothesis that autoantibodies at diagnosis are predictive for insulin treatment within 3 years in patients initially not classified as Type 1 diabetes. METHODS: In a nationwide population-based study, blood samples were obtained from 764 patients, all diagnosed with diabetes during a 2-year period. At diagnosis, 583 (76%) were classified as Type 1, 110 (14%) as Type 2 and 71 (9.3%) could not be classified. RESULTS: Among patients not classified as Type 1 diabetes, 52 (47%) of Type 2 and 42 (59%) of unclassified patients were positive for islet cell antibodies (ICA), glutamic acid decarboxylase antibodies (GADA) or tyrosine phosphatase antibodies (IA-2A). These patients (n=94) had lower body mass index (BMI) (p
PubMed ID
11114103 View in PubMed
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23 records – page 1 of 3.