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Accumulated exposure to unemployment is related to impaired glucose metabolism in middle-aged men: A follow-up of the Northern Finland Birth Cohort 1966.

https://arctichealth.org/en/permalink/ahliterature291192
Source
Prim Care Diabetes. 2017 Aug; 11(4):365-372
Publication Type
Comparative Study
Journal Article
Date
Aug-2017
Author
Nina Rautio
Tuulia Varanka-Ruuska
Eeva Vaaramo
Saranya Palaniswamy
Rozenn Nedelec
Jouko Miettunen
Jaro Karppinen
Juha Auvinen
Marjo-Riitta Järvelin
Sirkka Keinänen-Kiukaanniemi
Sylvain Sebert
Leena Ala-Mursula
Author Affiliation
Center for Life Course Health Research, University of Oulu, P.O. Box 5000, 90014 Oulu, Finland; Unit of Primary Health Care, Oulu University Hospital, OYS, P.O. Box 20, 90029 Oulu, Finland. Electronic address: nina.rautio@oulu.fi.
Source
Prim Care Diabetes. 2017 Aug; 11(4):365-372
Date
Aug-2017
Language
English
Publication Type
Comparative Study
Journal Article
Keywords
Age Factors
Biomarkers - blood
Blood Glucose - metabolism
Chi-Square Distribution
Diabetes Mellitus, Type 2 - blood - diagnosis - epidemiology
Female
Finland - epidemiology
Follow-Up Studies
Glucose Tolerance Test
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Prediabetic State - blood - diagnosis - epidemiology
Registries
Risk factors
Sex Factors
Surveys and Questionnaires
Time Factors
Unemployment
Abstract
We explored whether registered unemployment is associated with impaired glucose metabolism in general population.
Based on Northern Finland Birth Cohort 1966 at 46 years, we analyzed the oral glucose tolerance tests of 1970 men and 2544 women in relation to their preceding three-year employment records in three categories of unemployment exposure: no (employed), low (=1-year) and high exposure (>1-year).
Among men, pre-diabetes was found in 19.2% of those with no unemployment, 23.0% with low and 27.0% with high exposure, the corresponding figures for screen-detected type 2 diabetes were 3.8%, 3.8% and 9.2% (p
Notes
CommentIn: Prim Care Diabetes. 2018 Feb;12 (1):92 PMID 28807657
PubMed ID
28456438 View in PubMed
Less detail

Accuracy of GFR estimating equations combining standardized cystatin C and creatinine assays: a cross-sectional study in Sweden.

https://arctichealth.org/en/permalink/ahliterature270880
Source
Clin Chem Lab Med. 2015 Feb;53(3):403-14
Publication Type
Article
Date
Feb-2015
Author
Jonas Björk
Anders Grubb
Anders Larsson
Lars-Olof Hansson
Mats Flodin
Gunnar Sterner
Veronica Lindström
Ulf Nyman
Source
Clin Chem Lab Med. 2015 Feb;53(3):403-14
Date
Feb-2015
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Biomarkers - blood
Cohort Studies
Creatinine - blood
Cross-Sectional Studies
Cystatin C - blood
Female
Glomerular Filtration Rate
Humans
Male
Middle Aged
Renal Insufficiency, Chronic - blood - epidemiology
Sweden - epidemiology
Young Adult
Abstract
The recently established international cystatin C calibrator makes it possible to develop non-laboratory specific glomerular filtration rate (GFR) estimating (eGFR) equations. This study compares the performance of the arithmetic mean of the revised Lund-Malmö creatinine and CAPA cystatin C equations (MEANLM-REV+CAPA), the arithmetic mean of the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI) creatinine and cystatin C equations (MEANCKD-EPI), and the composite CKD-EPI equation (CKD-EPICREA+CYSC) with the corresponding single marker equations using internationally standardized calibrators for both cystatin C and creatinine.
The study included 1200 examinations in 1112 adult Swedish patients referred for measurement of GFR (mGFR) 2008-2010 by plasma clearance of iohexol (median 51 mL/min/1.73 m2). Bias, precision (interquartile range, IQR) and accuracy (percentage of estimates ±30% of mGFR; P30) were compared.
Combined marker equations were unbiased and had higher precision and accuracy than single marker equations. Overall results of MEANLM-REV+CAPA/MEANCKD-EPI/CKD-EPICREA+CYSC were: median bias -2.2%/-0.5%/-1.6%, IQR 9.2/9.2/8.8 mL/min/1.73 m2, and P30 91.3%/91.0%/91.1%. The P30 figures were about 7-14 percentage points higher than the single marker equations. The combined equations also had a more stable performance across mGFR, age and BMI intervals, generally with P30 =90% and never
PubMed ID
25274955 View in PubMed
Less detail

[Acute kidney injury and tubular biomarkers after hematopoietic stem cell transplantation].

https://arctichealth.org/en/permalink/ahliterature275530
Source
Ter Arkh. 2016;88(6):14-20
Publication Type
Article
Date
2016
Author
V A Dobronravov
K A Smirnov
B V Afanas'ev
O V Galkina
A V Smirnov
Source
Ter Arkh. 2016;88(6):14-20
Date
2016
Language
Russian
Publication Type
Article
Keywords
Acute Kidney Injury - diagnosis - etiology - metabolism - physiopathology
Adult
Biomarkers - blood
Chemokine CCL2 - blood
Female
Hematopoietic Stem Cell Transplantation - adverse effects
Humans
Kidney Function Tests
Kidney Tubules - metabolism - pathology - physiopathology
Male
Membrane Glycoproteins - blood
Middle Aged
Predictive value of tests
Prospective Studies
Receptors, Virus - blood
Reproducibility of Results
Russia
Abstract
To determine the value of molecular biomarkers (BMs) associated with tubular epithelial damage in developing and predicting acute kidney injury (AKI) after hematopoietic stem cell transplantation (HSCT).
The open-label observational prospective study enrolled 90 patients (46 males and 44 females) who had undergone HSCT. The concentrations of BMs (calbindin, clusterin, interleukin-18 (IL-18), kidney injury molecules-1 (KIM-1), glutathione S-transferase-p (GST-p), and monocyte chemoattractant protein-1 (MCP-1) were measured in urinary samples 7 days before HSCT (week 0) and at weeks 1, 2, 3, 4, and 5. Main clinical parameters were simultaneously monitored. AKI was diagnosed and stratified according to the Kidney Disease Improving Global Outcomes (KDIGO) guidelines.
At weeks 1, 2, 3, 4, and 5 after HSCT, the proportion of AKI cases was 7.8, 8.9, 12.5, 27.3, and 35.9%, respectively. The elevated urinary levels of BMs (above the median) were found to be substantially more common than AKI cases. The urinary excretion of the majority of BMs dramatically increased in the early HSCT period. The median number of simultaneously elevated BMs was 3 (2; 5) during the entire follow-up period. Clusterin, MCP-1 and KIM-1 positively and significantly correlated with serum creatinine at the week following the determination of BMs in the multivariate linear regression models adjusted for other confounders. The higher urinary KIM-1 and/or MCP-1 excretion regardless of other clinical indicators was associated with the higher relative risk (RR) of AKI, which increased by 2.3 times with a rise in one of these indicators and by 3.4 times with a rise in both indicators.
Multiple renal toxic effects after HSCT result in a substantial and simultaneous elevation of urinary excretion of BMs for tubular damage. Among the BMs studied, KIM-1 and MCP-1 seem to be the most suitable molecules for assessing the risk of AKI in this cohort of patient within the predictive diagnostic approach.
PubMed ID
27296256 View in PubMed
Less detail

Acute-phase proteins as diagnostic markers in horses with colic.

https://arctichealth.org/en/permalink/ahliterature281544
Source
J Vet Emerg Crit Care (San Antonio). 2016 Sep;26(5):664-74
Publication Type
Article
Date
Sep-2016
Author
Tina H Pihl
Elrien Scheepers
Macarena Sanz
Amelia Goddard
Patrick Page
Nils Toft
Mads Kjelgaard-Hansen
Pia H Andersen
Stine Jacobsen
Source
J Vet Emerg Crit Care (San Antonio). 2016 Sep;26(5):664-74
Date
Sep-2016
Language
English
Publication Type
Article
Keywords
Acute-Phase Proteins - metabolism
Animals
Ascitic Fluid - metabolism
Biomarkers - blood - metabolism
Colic - diagnosis - veterinary
Denmark
Female
Fibrinogen - metabolism
Haptoglobins - metabolism
Horse Diseases - blood - diagnosis
Horses
Male
Prospective Studies
Sensitivity and specificity
Serum Amyloid A Protein - metabolism
Abstract
To investigate the diagnostic potential of the concentrations of acute-phase proteins serum amyloid A (SAA), haptoglobin (Hp), and fibrinogen in blood and peritoneal fluid (PF) for differentiating horses with inflammatory colic (entero-colitis and peritonitis) from those with surgical colic.
Prospective observational multicenter study.
Two university referral hospitals.
Horses referred for severe acute abdominal pain to Hospital 1 (n = 148) or Hospital 2 (n = 78).
Blood and PF samples collected at admission were used for acute-phase protein concentration measurement.
A multivariable logistic model including clinical parameters (lethargy, rectal temperature >38°C [100.4°F], normal rectal examination findings, and gastric reflux of 5-10 L) recorded at admission was constructed from Hospital 1 data. The ability of the model to correctly differentiate inflammatory from surgical colic was 86% determined as area under the receiver operating characteristic curve. Adding blood parameters (WBC, PCV, total plasma protein, lactate, SAA, Hp, and fibrinogen concentrations) to the logistic model based on clinical parameters revealed that only WBC and SAA and fibrinogen concentrations improved the model. With SAA included in the model no additional blood parameters improved the model, and the final model had an area under the curve of 90%. Addition of PF parameters (hemolysis, total protein concentration, WBC, SAA, or Hp concentrations) did not improve the model. When validated in Hospital 2 data, the models had good integrity and diagnostic performance.
Evaluation of SAA in serum improved the ability to differentiate horses with acute inflammatory colic requiring medical treatment from horses with colic requiring surgery, as it allowed an additional 4% of horses to be correctly classified into medical and surgical cases. Improved differentiation of these 2 groups of horses with colic may minimize the risk of unnecessary or delayed surgery.
PubMed ID
27384962 View in PubMed
Less detail

Adding point of care ultrasound to assess volume status in heart failure patients in a nurse-led outpatient clinic. A randomised study.

https://arctichealth.org/en/permalink/ahliterature271711
Source
Heart. 2016 Jan;102(1):29-34
Publication Type
Article
Date
Jan-2016
Author
Guri Holmen Gundersen
Tone M Norekval
Hilde Haugberg Haug
Kyrre Skjetne
Jens Olaf Kleinau
Torbjorn Graven
Havard Dalen
Source
Heart. 2016 Jan;102(1):29-34
Date
Jan-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Biomarkers - blood
Cardiology Service, Hospital
Diuretics - administration & dosage
Drug Dosage Calculations
Female
Heart Failure - blood - drug therapy - nursing - physiopathology - ultrasonography
Humans
Linear Models
Logistic Models
Male
Middle Aged
Multivariate Analysis
Natriuretic Peptide, Brain - blood
Norway
Nursing Service, Hospital
Observer Variation
Outpatient Clinics, Hospital
Peptide Fragments - blood
Pleural Cavity - ultrasonography
Point-of-Care Systems
Point-of-Care Testing
Predictive value of tests
Prognosis
Prospective Studies
Reproducibility of Results
Vena Cava, Inferior - ultrasonography
Water-Electrolyte Balance - drug effects
Abstract
Medical history, physical examination and laboratory testing are not optimal for the assessment of volume status in heart failure (HF) patients. We aimed to study the clinical influence of focused ultrasound of the pleural cavities and inferior vena cava (IVC) performed by specialised nurses to assess volume status in HF patients at an outpatient clinic.
HF outpatients were prospectively included and underwent laboratory testing, history recording and clinical examination by two nurses with and without an ultrasound examination of the pleural cavities and IVC using a pocket-size imaging device, in random order. Each nurse worked in a team with a cardiologist. The influence of the different diagnostic tests on diuretic dosing was assessed descriptively and in linear regression analyses.
Sixty-two patients were included and 119 examinations were performed. Mean±SD age was 74±12 years, EF was 34±14%, and N-terminal pro-brain natriuretic peptide (NT-proBNP) value was 3761±3072 ng/L. Dosing of diuretics differed between the teams in 31 out of 119 consultations. Weight change and volume status assessed clinically with and without ultrasound predicted dose adjustment of diuretics at follow-up (p
Notes
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PubMed ID
26438785 View in PubMed
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The addition of S100B to guidelines for management of mild head injury is potentially cost saving.

https://arctichealth.org/en/permalink/ahliterature278895
Source
BMC Neurol. 2016 Oct 20;16(1):200
Publication Type
Article
Date
Oct-20-2016
Author
Olga Calcagnile
Anders Anell
Johan Undén
Source
BMC Neurol. 2016 Oct 20;16(1):200
Date
Oct-20-2016
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Biomarkers - blood
Brain Concussion - blood - diagnostic imaging - economics
Cost Savings
Female
Humans
Male
Middle Aged
Practice Guidelines as Topic
S100 Calcium Binding Protein beta Subunit - blood
Sweden
Young Adult
Abstract
Mild traumatic brain injury (TBI) is associated with substantial costs due to over-triage of patients to computed tomography (CT) scanning, despite validated decision rules. Serum biomarker S100B has shown promise for safely omitting CT scans but the economic impact from clinical use has never been reported. In 2007, S100B was adapted into the existing Scandinavian management guidelines in Halmstad, Sweden, in an attempt to reduce CT scans and save costs.
Consecutive adult patients with mild TBI (GCS 14-15, loss of consciousness and/or amnesia), managed with the aid of S100B, were prospectively included in this study. Patients were followed up after 3 months with a standardized questionnaire. Theoretical and actual cost differences were calculated.
Seven hundred twenty-six patients were included and 29 (4.7 %) showed traumatic abnormalities on CT. No further significant intracranial complications were discovered on follow-up. Two hundred twenty-nine patients (27 %) had normal S100B levels and 497 patients (73 %) showed elevated S100B levels. Over-triage occurred in 73 patients (32 %) and under-triage occurred in 39 patients (7 %). No significant intracranial complications were missed. The introduction of S100B could save 71 € per patient if guidelines were strictly followed. As compliance to the guidelines was not perfect, the actual cost saving was 39 € per patient.
Adding S100B to existing guidelines for mild TBI seems to reduce CT usage and costs, especially if guideline compliance could be increased.
PubMed ID
27765016 View in PubMed
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Adherence to national diabetes guidelines through monitoring quality indicators--A comparison of three types of care for the elderly with special emphasis on HbA1c.

https://arctichealth.org/en/permalink/ahliterature271560
Source
Prim Care Diabetes. 2015 Aug;9(4):253-60
Publication Type
Article
Date
Aug-2015
Author
Ann-Sofie Nilsson Neumark
Lars Brudin
Thomas Neumark
Source
Prim Care Diabetes. 2015 Aug;9(4):253-60
Date
Aug-2015
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Biomarkers - blood
Blood Glucose - drug effects - metabolism
Cross-Sectional Studies
Diabetes Mellitus, Type 1 - blood - diagnosis - drug therapy - epidemiology
Diabetes Mellitus, Type 2 - blood - diagnosis - drug therapy - epidemiology
Female
Guideline Adherence - standards
Health Services for the Aged - standards
Hemoglobin A, Glycosylated - metabolism
Home Care Services
Homes for the Aged
Humans
Hypoglycemic Agents - adverse effects - therapeutic use
Independent living
Male
Nursing Homes
Practice Guidelines as Topic - standards
Practice Patterns, Physicians' - standards
Prevalence
Process Assessment (Health Care) - standards
Quality Indicators, Health Care - standards
Sweden - epidemiology
Treatment Outcome
Abstract
To compare adherence to Swedish guidelines for diabetes care between elderly people living at home with or without home health care, and residents of nursing homes.
Medical records of 277 elderly people aged 80 and older, with known diabetes in a Swedish municipality, were monitored using quality indicators to evaluate processes and outcomes.
Monitoring, in accordance to diabetes guidelines, of HbA1c, lipids, blood pressure and foot examinations was lower among residents of nursing homes (p
PubMed ID
25865853 View in PubMed
Less detail

Adipose and Circulating CCL18 Levels Associate With Metabolic Risk Factors in Women.

https://arctichealth.org/en/permalink/ahliterature283211
Source
J Clin Endocrinol Metab. 2016 Nov;101(11):4021-4029
Publication Type
Article
Date
Nov-2016
Author
Daniel Eriksson Hogling
Paul Petrus
Hui Gao
Jesper Bäckdahl
Ingrid Dahlman
Jurga Laurencikiene
Juan Acosta
Anna Ehrlund
Erik Näslund
Agne Kulyte
Niklas Mejhert
Daniel P Andersson
Peter Arner
Mikael Rydén
Source
J Clin Endocrinol Metab. 2016 Nov;101(11):4021-4029
Date
Nov-2016
Language
English
Publication Type
Article
Keywords
Adiposity
Adult
Bariatric Surgery
Biomarkers - blood - metabolism
Body mass index
Cell Line
Cells, Cultured
Chemokines, CC - blood - genetics - metabolism - secretion
Cohort Studies
Female
Gene Expression Regulation
Gene Ontology
Humans
Hypertriglyceridemia - etiology
Insulin Resistance
Macrophages - immunology - metabolism - pathology - secretion
Metabolic Syndrome X - epidemiology - etiology
Obesity, Morbid - immunology - metabolism - pathology - physiopathology
Panniculitis - etiology
Recombinant Proteins - metabolism
Risk factors
Subcutaneous Fat, Abdominal - immunology - metabolism - pathology - secretion
Sweden - epidemiology
Abstract
Cardiometabolic complications in obesity may be linked to white adipose tissue (WAT) dysfunction. Transcriptomic studies of Sc WAT have reported that CCL18, encoding the CC chemokine ligand 18 (CCL18), is increased in obesity/insulin resistance but its functional role is unknown.
Our objectives were to determine if CCL18 is secreted from Sc WAT and if secreted and/or serum levels associate with metabolic phenotypes. We also planned to define the primary cellular source and if CCL18 exerts effects on adipocytes.
This is a cohort study.
The study took place in an outpatient academic clinic.
A total of 130 obese women scheduled for bariatric surgery and 35 nonobese controls were included.
Insulin sensitivity was assessed by hyperinsulinemic euglycemic clamp or homeostasis model assessment. CCL18 was analyzed in serum/WAT incubates by ELISA. Effects of recombinant CCL18 was determined in cultures of primary human adipocytes and the monocyte cell line THP-1 differentiated into M0/M1/M2 macrophages.
Association with metabolic risk factors was measured.
CCL18 was secreted from WAT and the levels correlated positively with insulin resistance, Adult Treatment Panel III risk score and plasma triglycerides, independent of body mass index and better than other established adipocytokines. In 80 obese women, S-CCL18 levels were significantly higher in insulin resistant compared with insulin sensitive subjects. In WAT CCL18 mRNA was expressed in macrophages and correlated positively with immune-related genes, particularly those enriched in M2 macrophages. While CCL18 increased cyto-/chemokine expression in M0/M2-THP-1 cells, human adipocytes showed no responses in vitro.
Circulating and WAT-secreted CCL18 correlates with insulin resistance and metabolic risk score. Because CCL18 is macrophage-specific and associates with adipose immune gene expression, it may constitute a marker of WAT inflammation.
PubMed ID
27459538 View in PubMed
Less detail

Aerobic fitness is associated with low cardiovascular disease risk: the impact of lifestyle on early risk factors for atherosclerosis in young healthy Swedish individuals - the Lifestyle, Biomarker, and Atherosclerosis study.

https://arctichealth.org/en/permalink/ahliterature284719
Source
Vasc Health Risk Manag. 2017;13:91-99
Publication Type
Article
Date
2017
Author
Maria Fernström
Ulrika Fernberg
Gabriella Eliason
Anita Hurtig-Wennlöf
Source
Vasc Health Risk Manag. 2017;13:91-99
Date
2017
Language
English
Publication Type
Article
Keywords
Age Factors
Biomarkers - blood
Cardiorespiratory fitness
Carotid Artery Diseases - blood - diagnostic imaging - epidemiology - prevention & control
Carotid Intima-Media Thickness
Cross-Sectional Studies
Dyslipidemias - blood - epidemiology - prevention & control
Exercise Test
Feeding Behavior
Hand Strength
Healthy Diet
Healthy Volunteers
Humans
Insulin Resistance
Muscle strength
Prevalence
Prognosis
Protective factors
Risk assessment
Risk factors
Risk Reduction Behavior
Surveys and Questionnaires
Sweden - epidemiology
Time Factors
Young Adult
Abstract
The progression of cardiovascular disease (CVD) and atherosclerosis is slow and develops over decades. In the cross-sectional Swedish Lifestyle, Biomarker, and Atherosclerosis study, 834 young, self-reported healthy adults aged 18.0-25.9 years have been studied to identify early risk factors for atherosclerosis.
The aims of this study were to 1) assess selected cardiometabolic biomarkers, carotid intima-media thickness (cIMT) as a marker of subclinical atherosclerosis, and lifestyle-related indicators (food habits, handgrip strength, and oxygen uptake, VO2 max); 2) analyze the associations between cIMT and lifestyle factors; and 3) identify subjects at risk of CVD using a risk score and to compare the characteristics of subjects with and without risk of CVD.
Blood samples were taken in a fasting state, and food habits were reported through a questionnaire. cIMT was measured by ultrasound, and VO2 max was measured by ergometer bike test. The risk score was calculated according to Wildman.
cIMT (mean ± standard deviation) was 0.50±0.06 mm, and VO2 max values were 37.8±8.5 and 42.9±9.9 mL/kg/min, in women and men, respectively. No correlation was found between aerobic fitness expressed as VO2 max (mL/kg/min) and cIMT. Using Wildman's definition, 12% of the subjects were classified as being at risk of CVD, and 15% had homeostasis model assessment of insulin resistance. A total of 35% of women and 25% of men had lower high-density lipoprotein cholesterol than recommended. Food habits did not differ between those at risk and those not at risk. However, aerobic fitness measured as VO2 max (mL/kg/min) differed; 47% of the subjects at risk had low aerobic fitness compared to 23% of the nonrisk subjects (P
Notes
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PubMed ID
28352184 View in PubMed
Less detail

Affect school and script analysis versus basic body awareness therapy in the treatment of psychological symptoms in patients with diabetes and high HbA1c concentrations: two study protocols for two randomized controlled trials.

https://arctichealth.org/en/permalink/ahliterature279373
Source
Trials. 2016 Apr 27;17(1):221
Publication Type
Article
Date
Apr-27-2016
Author
Eva O Melin
Ralph Svensson
Sven-Åke Gustavsson
Agneta Winberg
Ewa Denward-Olah
Mona Landin-Olsson
Hans O Thulesius
Source
Trials. 2016 Apr 27;17(1):221
Date
Apr-27-2016
Language
English
Publication Type
Article
Keywords
Biomarkers - blood
Body Image
Clinical Protocols
Cognitive Therapy - methods
Diabetes Mellitus, Type 1 - blood - diagnosis - psychology - therapy
Diabetes Mellitus, Type 2 - blood - diagnosis - psychology - therapy
Health Knowledge, Attitudes, Practice
Hemoglobin A, Glycosylated - analysis
Humans
Mind-Body Therapies - methods
Patient Education as Topic
Psychiatric Status Rating Scales
Research Design
Surveys and Questionnaires
Sweden
Time Factors
Treatment Outcome
Up-Regulation
Abstract
Depression is linked with alexithymia, anxiety, high HbA1c concentrations, disturbances of cortisol secretion, increased prevalence of diabetes complications and all-cause mortality. The psycho-educational method 'affect school with script analysis' and the mind-body therapy 'basic body awareness treatment' will be trialled in patients with diabetes, high HbA1c concentrations and psychological symptoms. The primary outcome measure is change in symptoms of depression. Secondary outcome measures are changes in HbA1c concentrations, midnight salivary cortisol concentration, symptoms of alexithymia, anxiety, self-image measures, use of antidepressants, incidence of diabetes complications and mortality.
Two studies will be performed. Study I is an open-labeled parallel-group study with a two-arm randomized controlled trial design. Patients are randomized to either affect school with script analysis or to basic body awareness treatment. According to power calculations, 64 persons are required in each intervention arm at the last follow-up session. Patients with type 1 or type 2 diabetes were recruited from one hospital diabetes outpatient clinic in 2009. The trial will be completed in 2016. Study II is a multicentre open-labeled parallel-group three-arm randomized controlled trial. Patients will be randomized to affect school with script analysis, to basic body awareness treatment, or to treatment as usual. Power calculations show that 70 persons are required in each arm at the last follow-up session. Patients with type 2 diabetes will be recruited from primary care. This study will start in 2016 and finish in 2023. For both studies, the inclusion criteria are: HbA1c concentration =62.5 mmol/mol; depression, alexithymia, anxiety or a negative self-image; age 18-59 years; and diabetes duration =1 year. The exclusion criteria are pregnancy, severe comorbidities, cognitive deficiencies or inadequate Swedish. Depression, anxiety, alexithymia and self-image are assessed using self-report instruments. HbA1c concentration, midnight salivary cortisol concentration, blood pressure, serum lipid concentrations and anthropometrics are measured. Data are collected from computerized medical records and the Swedish national diabetes and causes of death registers.
Whether the "affect school with script analysis" will reduce psychological symptoms, increase emotional awareness and improve diabetes related factors will be tried, and compared to "basic body awareness treatment" and treatment as usual.
ClinicalTrials.gov: NCT01714986.
Notes
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PubMed ID
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