To test the hypothesis that the genetic susceptibility to non-insulin dependent diabetes mellitus is the same as that to insulin dependent disease and to see whether glucose intolerance is associated with specific HLA haplotypes.
Population based study of men in 1989 first tested for glucose tolerance in 1984. HLA haplotypes, including HLA-A, C, B, DR, and DQ, were defined serologically. HLA haplotype data from a population based Finnish study of childhood diabetes were used for predicting non-insulin dependent diabetes and impaired glucose tolerance.
Two communities in Finland.
Representative cohort of Finnish men aged 70-89, comprising 98 men with non-insulin dependent diabetes mellitus and a randomly selected group of 74 men, who served as controls, who were tested for glucose tolerance twice within five years.
Diabetes associated HLA haplotypes were present in 94% (85/90) of diabetic subjects, 79% (27/34) of subjects with impaired glucose tolerance, and only 13% (3/23) of non-diabetic subjects. In this group of elderly men sensitivity of the diabetes associated HLA haplotypes for non-insulin dependent diabetes and impaired glucose tolerance was 90%, specificity 87%, and predictive power 97%. Mean fasting blood glucose concentration was only just significantly higher in men with diabetes associated haplotypes than in men with no such haplotypes, but there was a substantial difference in blood glucose values two hours after glucose loading (10.4 and 6.4 mmol/l in men with diabetes associated HLA haplotypes and men with no such haplotypes, respectively (p
A 25-year follow-up survey of the Finnish men examined in the Seven Countries Study and now 65-84 years old was carried out in the East and the South-West of Finland in 1984. The follow-up examinations were carried out as in the previous surveys. Systolic and diastolic blood pressures were now significantly lower in the East than in the South-West of Finland. Serum total cholesterol and HDL-cholesterol were on the same level in both areas. The East/South-West difference in serum cholesterol, observed in previous studies, had levelled off and that in the blood pressure level had even reversed among the study cohorts. The mean fasting serum glucose was higher in the East than in the South-West of Finland. The mean serum calcium level was the same in both areas.
To map and identify susceptibility genes for NIDDM and for the intermediate quantitative traits associated with NIDDM.
We describe the methodology and sample of the Finland-United States Investigation of NIDDM Genetics (FUSION) study. The whole genome search approach is being applied in studies of several different ethnic groups to locate susceptibility genes for NIDDM. Detailed description of the study materials and designs of such studies are important, particularly when comparing the findings in these studies and when combining different data sets.
Using a careful selection strategy, we have ascertained 495 families with confirmed NIDDM in at least two siblings and no history of IDDM among the first-degree relatives. These families were chosen from more than 22,000 NIDDM patients, representative of patients with NIDDM in the Finnish population. In a subset of families, a spouse and offspring were sampled, and they participated in a frequently sampled intravenous glucose tolerance test (FSIGT) analyzed with the Minimal Model. An FSIGT was completed successfully for at least two nondiabetic offspring in 156 families with a confirmed nondiabetic spouse and no history of IDDM in first-degree relatives.
Our work demonstrates the feasibility of collecting a large number of affected sib-pair families with NIDDM to provide data that will enable a whole genome search approach, including linkage analysis.
We studied the prevalence of diabetes mellitus in men aged 65 to 84 years in Finland. The study sample consisted of 763 men, the survivors of the Finnish cohort of the "Seven Countries Study" first examined in 1959. The participation rate in the present survey was 94%. Blood glucose, fasting and 2 h after a 75-g oral glucose load, was determined from capillary blood. Current WHO criteria for diabetes mellitus were used. The mean fasting blood glucose level, adjusted for age and body mass index, was higher in east than west Finland. It rose with age in both areas. The prevalence of diabetes was 38% in the east and 36% in west Finland. About one-third of the men had impaired glucose tolerance. In the age group 75 to 79 years, the prevalence of diabetes was 65% in the east and 50% in the west. No systematic variation in the prevalence of impaired glucose tolerance with age was found. The mean levels of body mass index decreased with age in the same way in men with diabetes, impaired glucose tolerance and normal glucose tolerance. Body mass index was not higher in men with diabetes or impaired glucose tolerance than in men with normal glucose tolerance.
Prevention of Type II diabetes in subjects with impaired glucose tolerance: the Diabetes Prevention Study (DPS) in Finland. Study design and 1-year interim report on the feasibility of the lifestyle intervention programme.
AIMS/HYPOTHESIS; The aim of the Diabetes Prevention Study is to assess the efficacy of an intensive diet-exercise programme in preventing or delaying Type II (non-insulin-dependent) diabetes mellitus in subjects with impaired glucose tolerance, to evaluate the effects of the intervention programme on cardiovascular risk factors and to assess the determinants for the progression to diabetes in persons with impaired glucose tolerance.
A total of 523 overweight subjects with impaired glucose tolerance ascertained by two oral glucose tolerance tests were randomised to either a control or intervention group. The control subjects received general information at the start of the trial about the lifestyle changes necessary to prevent diabetes and about annual follow-up visits. The intervention subjects had seven sessions with a nutritionist during the first year and a visit every 3 months thereafter aimed at reducing weight, the intake of saturated fat and increasing the intake of dietary fibre. Intervention subjects were also guided individually to increase their physical activity.
During the first year, weight loss in the first 212 study subjects was 4.7 +/- 5.5 vs 0.9 +/- 4.1 kg in the intervention and control group, respectively (p