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Abdominal fat from spine dual-energy x-ray absorptiometry and risk for subsequent diabetes.

https://arctichealth.org/en/permalink/ahliterature144207
Source
J Clin Endocrinol Metab. 2010 Jul;95(7):3272-6
Publication Type
Article
Date
Jul-2010
Author
William D Leslie
Sora M Ludwig
Suzanne Morin
Author Affiliation
University of Manitoba, Winnipeg, Canada R2H 2A6. bleslie@sbgh.mb.ca
Source
J Clin Endocrinol Metab. 2010 Jul;95(7):3272-6
Date
Jul-2010
Language
English
Publication Type
Article
Keywords
Absorptiometry, Photon
Adult
Aged
Aged, 80 and over
Area Under Curve
Body Composition
Bone Density
Canada
Cohort Studies
Diabetes Mellitus, Type 2 - complications - diagnosis
Female
Health Surveys
Humans
Insulin Resistance
Middle Aged
Obesity, Abdominal - complications - diagnosis
Predictive value of tests
Risk factors
Abstract
Abdominal obesity is a major risk factor for diabetes. Dual-energy x-ray absorptiometry (DXA) of the lumbar spine provides an index of abdominal fat.
Our objective was to examine the hypothesis that DXA-derived abdominal fat measurement in women undergoing osteoporosis investigation predicts risk for subsequent diagnosis of diabetes.
This historical cohort study was derived from the Manitoba Bone Density Program Database for the Province of Manitoba, Canada.
30,252 nondiabetic women aged 40 yr and older were referred for baseline osteoporosis assessment with DXA between January 1990 and March 2007.
Each woman's longitudinal provincial health service record was assessed for the presence of diabetes diagnosis codes after DXA testing.
During 5.2 + or - 2.6 yr of observation, 1252 (4.1%) women met the case definition for diabetes. A greater proportion of abdominal fat from spine DXA was strongly related to subsequent diabetes diagnosis in models adjusted for age, body mass index, and other comorbidities. Those in the highest quintile had 3.56 (95% confidence interval = 2.67-4.75) times the risk for subsequent diabetes diagnosis compared with those in the lowest (reference) quintile. Fat from hip DXA was not predictive of subsequent diabetes after adjustment for the same variables (1.00, 95% confidence interval = 0.79-1.26).
Predictive information about diabetes risk can be obtained from spine DXA scans performed for osteoporosis risk assessment. This is consistent with evidence linking abdominal fat with insulin resistance and the metabolic syndrome.
PubMed ID
20392865 View in PubMed
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Anxiety and Depressive Symptoms as Predictors of All-Cause Mortality among People with Insulin-Naïve Type 2 Diabetes: 17-Year Follow-Up of the Second Nord-Trøndelag Health Survey (HUNT2), Norway.

https://arctichealth.org/en/permalink/ahliterature284783
Source
PLoS One. 2016;11(8):e0160861
Publication Type
Article
Date
2016
Author
Marjolein M Iversen
Giesje Nefs
Grethe S Tell
Birgitte Espehaug
Kristian Midthjell
Marit Graue
Frans Pouwer
Source
PLoS One. 2016;11(8):e0160861
Date
2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anxiety - complications
Depression - complications
Diabetes Mellitus, Type 2 - complications - diagnosis - epidemiology - mortality
Female
Follow-Up Studies
Hemoglobin A, Glycosylated - analysis
Humans
Male
Middle Aged
Norway - epidemiology
Prognosis
Abstract
To examine whether elevated anxiety and/or depressive symptoms are related to all-cause mortality in people with Type 2 diabetes, not using insulin.
948 participants in the community-wide Nord-Trøndelag Health Survey conducted during 1995-97 completed the Hospital Anxiety and Depression Scale with subscales of anxiety (HADS-A) and depression (HADS-D). Elevated symptoms were defined as HADS-A or HADS-D =8. Participants with type 2 diabetes, not using insulin, were followed until November 21, 2012 or death. Cox regression analyses were used to estimate associations between baseline elevated anxiety symptoms, elevated depressive symptoms and mortality, adjusting for sociodemographic factors, HbA1c, cardiovascular disease and microvascular complications.
At baseline, 8% (n = 77/948) reported elevated anxiety symptoms, 9% (n = 87/948) elevated depressive symptoms and 10% (n = 93/948) reported both. After a mean follow-up of 12 years (SD 5.1, range 0-17), 541 participants (57%) had died. Participants with elevated anxiety symptoms only had a decreased mortality risk (unadjusted HR 0.66, 95% CI 0.46-0.96). Adjustment for HbA1c attenuated this relation (HR 0.73, 95% CI 0.50-1.07). Those with elevated depression symptoms alone had an increased mortality risk (fully adjusted model HR 1.39, 95% CI 1.05-1.84). Having both elevated anxiety and depressive symptoms was not associated with increased mortality risk (adjusted HR 1.30, 95% CI 0.96-1.74).
Elevated depressive symptoms were associated with excess mortality risk in people with Type 2 diabetes not using insulin. No significant association with mortality was found among people with elevated anxiety symptoms. Having both elevated anxiety and depressive symptoms was not associated with mortality. The hypothesis that elevated levels of anxiety symptoms leads to behavior that counteracts the adverse health effects of Type 2 diabetes needs further investigation.
Notes
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PubMed ID
27537359 View in PubMed
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Clinical features of bipolar disorder with and without comorbid diabetes mellitus.

https://arctichealth.org/en/permalink/ahliterature183679
Source
Can J Psychiatry. 2003 Aug;48(7):458-61
Publication Type
Article
Date
Aug-2003
Author
Martina Ruzickova
Claire Slaney
Julie Garnham
Martin Alda
Author Affiliation
Department of Psychiatry, Dalhousie University, 5909 Jubilee Road, Halifax, NS B3H 2E2. mruzicko@dal.ca
Source
Can J Psychiatry. 2003 Aug;48(7):458-61
Date
Aug-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Bipolar Disorder - complications - diagnosis - epidemiology
Canada - epidemiology
Comorbidity
Diabetes Mellitus, Type 2 - complications - diagnosis - epidemiology
Female
Humans
Male
Middle Aged
Registries
Regression Analysis
Risk factors
Abstract
Several papers have reported higher prevalence of diabetes mellitus (DM) type 2 in patients suffering from bipolar disorder (BD). The possible links between these 2 disorders include treatment, lifestyle, alterations in signal transduction, and possibly, a genetic link. To study this relation more closely, we investigated whether there are any differences in the clinical characteristics of BD patients with and without DM.
We compared the clinical data of 26 diabetic and 196 nondiabetic subjects from The Maritime Bipolar Registry. Subjects were aged 15 to 82 years, with psychiatric diagnoses of BD I (n = 151), BD II (n = 65), and BD not otherwise specified (n = 6). The registry included basic demographic data and details on the clinical course of bipolar illness, its treatment, and physical comorbidity. In a subsequent analysis using logistic regression, we examined the variables showing differences between groups, with diabetes as an outcome variable.
The prevalence of DM in our sample was 11.7% (n = 26). Diabetic patients were significantly older than nondiabetic patients (P
PubMed ID
12971015 View in PubMed
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Concordance between elderly patients' understanding of and their primary healthcare physician's diagnosis of heart failure.

https://arctichealth.org/en/permalink/ahliterature82235
Source
Scand J Prim Health Care. 2006 Jun;24(2):110-4
Publication Type
Article
Date
Jun-2006
Author
Halling Anders
Berglund Johan
Author Affiliation
Blekinge Institute for Research & Development, Karlshamn, Sweden.
Source
Scand J Prim Health Care. 2006 Jun;24(2):110-4
Date
Jun-2006
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cognition Disorders - complications
Cohort Studies
Cross-Sectional Studies
Diabetes Mellitus, Type 2 - complications - diagnosis
Family Practice
Female
Heart Failure, Congestive - complications - diagnosis
Humans
Male
Middle Aged
Patient compliance
Physician-Patient Relations
Questionnaires
Sweden
Abstract
OBJECTIVE: The objective was to study primary healthcare patients' understanding of their diagnosis of heart failure (HF), using patients treated for diabetes mellitus (DM) as a comparative group. DESIGN: A cross-sectional community based study. SETTING: Karlskrona community situated on the Swedish south-east coast with 60,600 inhabitants. SUBJECTS: A total of 1402 subjects, aged 60-96 years in 10 age cohorts, selected randomly from the national population registry participating in the Swedish National study on Ageing and Care - Blekinge. MAIN OUTCOME MEASURES: Understanding of diagnosis of HF or DM in primary healthcare. Prevalence of cognitive impairment. RESULTS: In all, 39.8% of patients with a diagnosis of HF treated in primary healthcare and 97.1% of patients with DM had an understanding of their respective diagnosis. Cognitive impairment was significantly more prevalent in the groups of patients treated for HF (OR 1.9, 95% CI 1.2 to 3.0) and DM (OR 1.8, 95% CI 1.1 to 3.1), when compared with those not treated for either HF or DM. The odds ratio for understanding of diagnosis was 0.013 (95% CI 0.003 to 0.052, p
PubMed ID
16690560 View in PubMed
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Effects of diabetes mellitus on patients with acute intermittent porphyria.

https://arctichealth.org/en/permalink/ahliterature21165
Source
J Intern Med. 1999 Feb;245(2):193-7
Publication Type
Article
Date
Feb-1999
Author
C. Andersson
I. Bylesjö
F. Lithner
Author Affiliation
Primary Health Care Centre, Arjeplog, Sweden.
Source
J Intern Med. 1999 Feb;245(2):193-7
Date
Feb-1999
Language
English
Publication Type
Article
Keywords
Age of Onset
Aged
Aged, 80 and over
Carcinoma, Hepatocellular - complications
Diabetes Mellitus, Type 2 - complications - diagnosis - urine
Female
Hospitalization
Humans
Liver Neoplasms - complications
Male
Middle Aged
Porphobilinogen - urine
Porphyria, Acute Intermittent - complications - urine
Research Support, Non-U.S. Gov't
Sweden
Abstract
OBJECTIVES: To study the effects of diabetes mellitus in patients with acute intermittent porphyria (AIP). Haeme deficiency in the liver of AIP patients stimulates an increase in ALA-synthase which triggers an escalating metabolic chain reaction, leading to an increase in the porphyrin content. This reaction can be reduced by treating AIP patients with haeme arginate or with glucose. DESIGN: A population-based study of all patients > 18 years of age having DNA-verified AIP (n = 328) living in the two most northerly counties of Sweden (Norrbotten and Västerbotten, with 550,000 inhabitants) of whom 16 had type 2 diabetes. Prevalence of diabetes was studied retrospectively in 26 AIP patients with hepatocellular carcinoma (HCC). RESULTS: None of the patients showed symptoms of AIP after the onset of their diabetes. Three patients had had recurrent, severe attacks for many years but when their diabetes became manifest, their urinary ALA and PBG levels decreased and the AIP symptoms resolved, to the relief of the patients. Amongst the 26 AIP patients with HCC, only one with signs of diabetes was identified (impaired glucose tolerance test). CONCLUSIONS: This study raises the possibility that diabetes mellitus may be beneficial for patients with severe AIP.
PubMed ID
10081522 View in PubMed
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Predicting mortality in people with type 2 diabetes mellitus after major complications: a study using Swedish National Diabetes Register data.

https://arctichealth.org/en/permalink/ahliterature261400
Source
Diabet Med. 2014 Aug;31(8):954-62
Publication Type
Article
Date
Aug-2014
Author
P J Kelly
P M Clarke
A J Hayes
U-G Gerdtham
J. Cederholm
P. Nilsson
B. Eliasson
S. Gudbjornsdottir
Source
Diabet Med. 2014 Aug;31(8):954-62
Date
Aug-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Amputation - adverse effects
Diabetes Mellitus, Type 2 - complications - diagnosis - epidemiology - mortality
Diabetic Angiopathies - mortality - surgery
Diabetic Cardiomyopathies - mortality
Diabetic Nephropathies - mortality
Female
Follow-Up Studies
Heart Failure - complications - mortality
Humans
Life expectancy
Male
Models, Biological
Mortality
Myocardial Infarction - complications - mortality
Prognosis
Prospective Studies
Registries
Renal Insufficiency - complications - mortality
Risk factors
Stroke - complications - mortality
Sweden - epidemiology
Abstract
To predict mortality risk and life expectancy for patients with type 2 diabetes after a major diabetes-related complication.
The study sample, taken from the Swedish National Diabetes Register, consisted of 20 836 people with type 2 diabetes who had their first major complication (myocardial infarction, stroke, heart failure, amputation or renal failure) between January 2001 and December 2007. A Gompertz proportional hazards model was derived which determined significant risk factors associated with mortality and was used to estimate life expectancies.
Risk of death changed over time according to type of complication, with myocardial infarction initally having the highest initial risk of death, but after the first month, the risk was higher for heart failure, renal failure and amputation. Other factors that increased the risk of death were male gender (hazard ratio 1.06, 95% CI 1.02-1.12), longer duration of diabetes (hazard ratio 1.07 per 10 years, 95% CI 1.04-1.10), smoking (hazard ratio 1.51, 95% CI 1.40-1.63) and macroalbuminuria (hazard ratio 1.14, 95% CI 1.06-1.22). Low BMI, low systolic blood pressure and low estimated GFR also increased mortality risk. Life expectancy was highest after a stroke, myocardial infarction or heart failure, lower after amputation and lowest after renal failure. Smoking and poor renal function were the risk factors which had the largest impact on reducing life expectancy.
Risk of death and life expectancy differs substantially among the major complications of diabetes, and factors significantly increasing risk included smoking, low estimated GFR and albuminuria.
PubMed ID
24750341 View in PubMed
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[Quality indicators for type 2 diabetes at referral to diabetes centre].

https://arctichealth.org/en/permalink/ahliterature139942
Source
Ugeskr Laeger. 2010 Oct 11;172(41):2832-6
Publication Type
Article
Date
Oct-11-2010
Author
Fie Gregersen Møller
Rune Lykke
Lone Kaersvang
Morten Vildhøj
Sara Vildhøj
Charlotte Melchior Bendtsen
Trine Andersen
Rikke Lund Nielsen
Klavs Würgler Hansen
Author Affiliation
Regionshospitalet Silkeborg, Medicinsk Afdeling, Denmark. fiegregersen@hotmail.com
Source
Ugeskr Laeger. 2010 Oct 11;172(41):2832-6
Date
Oct-11-2010
Language
Danish
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Albuminuria
Denmark
Diabetes Complications - diagnosis - prevention & control
Diabetes Mellitus, Type 2 - complications - diagnosis - therapy
Family Practice
Hemoglobin A, Glycosylated - analysis
Humans
Middle Aged
Outpatient Clinics, Hospital
Quality Indicators, Health Care
Referral and Consultation
Retrospective Studies
Abstract
The Danish National Board of Health recommends graduated care of type 2 diabetes patients based on risk stratification. This requires a systematic monitoring of indicators for the development of complications.
Retrospective evaluation of type 2 diabetes patients referred from general practice in the 2004-2007 period.
1) Diabetes duration = two years, 2) Diabetes control exclusively handled in primary care in the previous two years, 3) Referred from general practice to outpatient assessment by the diabetes centre, 4) The physician used a laboratory affiliated to the Aarhus County laboratory database, 5) Written referral could be found. Data was gathered by reviewing records, searching the laboratory database and register of diabetic eye care service.
A total of 97 patients were included. By the time at referral (mean): Age 61.5 years, diabetes duration 8.4 years, body mass index 31.7 kg/m2. In the last two years before referral, the following percentage had at least one p-lipid measurement: 85%, eye examination: 61% and measurement of microalbuminuria: 53%. HbA1c at referral was 9.0% (n = 97), 9.1% (n = 93) seven months before and 8.7% (n = 82) 20 months before referral.
Glycaemic control was poor 20 months before referral. The prerequisites for the recommendation of The Danish National Board of Health was not present since eye examination was not performed in 39% and assessment of microalbuminuria was not performed in 47% of the patients in the previous two years before referral.
PubMed ID
20961503 View in PubMed
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