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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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Cognitive impairment: an increasingly important complication of type 2 diabetes: the age, gene/environment susceptibility--Reykjavik study.

https://arctichealth.org/en/permalink/ahliterature91773
Source
Am J Epidemiol. 2008 Nov 15;168(10):1132-9
Publication Type
Article
Date
Nov-15-2008
Author
Saczynski Jane S
Jónsdóttir María K
Garcia Melissa E
Jonsson Palmi V
Peila Rita
Eiriksdottir Gudny
Olafsdottir Elin
Harris Tamara B
Gudnason Vilmundur
Launer Lenore J
Author Affiliation
Division of Geriatric Medicine, University of Massachusetts Medical School, Biotech Four, Suite 315, 377 Plantation Street, Worcester, MA 01605, USA. jane.saczynski@umassmed.edu
Source
Am J Epidemiol. 2008 Nov 15;168(10):1132-9
Date
Nov-15-2008
Language
English
Publication Type
Article
Keywords
Aged
Blood glucose
Cognition Disorders - diagnosis - epidemiology - etiology
Cohort Studies
Diabetes Mellitus, Type 2 - complications - diagnosis - epidemiology
Environment
Fasting - blood
Female
Genetic Predisposition to Disease
Glycemic Index
Hemoglobin A, Glycosylated
Humans
Iceland - epidemiology
Logistic Models
Male
Psychological Tests
Questionnaires
Abstract
Persons with type 2 diabetes are at increased risk of cognitive dysfunction. Less is known about which cognitive abilities are affected and how undiagnosed diabetes and impaired fasting glucose relate to cognitive performance. The authors explored this question using data from 1,917 nondemented men and women (average age = 76 years) in the population-based Age, Gene/Environment Susceptibility-Reykjavik Study (2002-2006). Glycemic status groups included diagnosed diabetes (self-reported diabetes or diabetic medication use; n = 163 (8.5%)), undiagnosed diabetes (fasting blood glucose >or=7.0 mmol/L without diagnosed diabetes; n = 55 (2.9%)), and impaired fasting glucose (fasting blood glucose 5.6-6.9 mmol/L; n = 744 (38.8%)). Composites of memory, processing speed (PS), and executive function were constructed from a neuropsychological battery. Linear regression was used to investigate cross-sectional differences in cognitive performance between glycemic groups, adjusted for demographic and health factors. Persons with diagnosed diabetes had slower PS than normoglycemics (beta = -0.12; P or=15 years was associated with significantly poorer PS and executive function. Undiagnosed diabetics had slower PS (beta = -0.22; P
PubMed ID
18836152 View in PubMed
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Cross-sectional evaluation of the Finnish Diabetes Risk Score: a tool to identify undetected type 2 diabetes, abnormal glucose tolerance and metabolic syndrome.

https://arctichealth.org/en/permalink/ahliterature171838
Source
Diab Vasc Dis Res. 2005 May;2(2):67-72
Publication Type
Article
Date
May-2005
Author
Timo Saaristo
Markku Peltonen
Jaana Lindström
Liisa Saarikoski
Jouko Sundvall
Johan Gunnar Eriksson
Jaakko Tuomilehto
Author Affiliation
Finnish Diabetes Association, Tampere, Finland.
Source
Diab Vasc Dis Res. 2005 May;2(2):67-72
Date
May-2005
Language
English
Publication Type
Article
Keywords
Aged
Cardiovascular Diseases - etiology
Cross-Sectional Studies
Diabetes Mellitus, Type 2 - complications - diagnosis - epidemiology
False Positive Reactions
Female
Finland
Glucose Intolerance - complications - diagnosis - epidemiology
Humans
Male
Mass Screening
Metabolic Syndrome X - complications - diagnosis - epidemiology
Middle Aged
Predictive value of tests
Prevalence
Questionnaires
ROC Curve
Risk factors
Abstract
The aim of this study was to assess the performance of the Finnish Diabetes Risk Score as a screening tool for undetected type 2 diabetes (T2D), abnormal glucose tolerance (AGT) and metabolic syndrome in the general population. In a cross-sectional, population-based survey, a total of 4,622 subjects aged 45-74 years were invited to a health examination that included an oral glucose tolerance test. Full data with risk score estimate and glucose tolerance status were available for 2,966 subjects without a prior history of diabetes. The risk score was associated with the presence of previously undiagnosed T2D, AGT, metabolic syndrome and cardiovascular risk factors. The area under the receiver operating curve for the prevalence of undiagnosed diabetes was 0.72 in men and 0.73 in women. The sensitivity using a cutoff risk score of 11 to identify undiagnosed diabetes was 66% in men and 70% in women; the corresponding false-positive rates were 31% and 39%, respectively. The area under the receiver operating curve for detecting the metabolic syndrome was 0.72 in men and 0.75 in women. The Finnish Diabetes Risk Score can be used as a self-administered test to screen subjects at high risk for T2D. It can also be used in the general population and clinical practice to identify undetected T2D, AGT and the metabolic syndrome.
PubMed ID
16305061 View in PubMed
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A diagnosis of the metabolic syndrome in youth that resolves by adult life is associated with a normalization of high carotid intima-media thickness and type 2 diabetes mellitus risk: the Bogalusa heart and cardiovascular risk in young Finns studies.

https://arctichealth.org/en/permalink/ahliterature120285
Source
J Am Coll Cardiol. 2012 Oct 23;60(17):1631-9
Publication Type
Article
Date
Oct-23-2012
Author
Costan G Magnussen
Juha Koskinen
Markus Juonala
Wei Chen
Sathanur R Srinivasan
Matthew A Sabin
Russell Thomson
Michael D Schmidt
Quoc Manh Nguyen
Ji-Hua Xu
Michael R Skilton
Mika Kähönen
Tomi Laitinen
Leena Taittonen
Terho Lehtimäki
Tapani Rönnemaa
Jorma S A Viikari
Gerald S Berenson
Olli T Raitakari
Author Affiliation
Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland. cmagnuss@utas.edu.au
Source
J Am Coll Cardiol. 2012 Oct 23;60(17):1631-9
Date
Oct-23-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aging
Cardiovascular Diseases - diagnosis - epidemiology - etiology
Carotid Intima-Media Thickness
Child
Diabetes Mellitus, Type 2 - complications - diagnosis - epidemiology
Female
Finland - epidemiology
Follow-Up Studies
Humans
Male
Metabolic Syndrome X - complications - diagnosis - epidemiology
Prevalence
Prognosis
Remission, Spontaneous
Retrospective Studies
Risk factors
Time Factors
Young Adult
Abstract
The aim of this study was to examine the effect of resolution from metabolic syndrome (MetS) between youth and adulthood on carotid artery intima-media thickness (IMT) and type 2 diabetes mellitus (T2DM).
Published findings demonstrate that youth with MetS are at increased risk of cardio-metabolic outcomes in adulthood. It is not known whether this risk is attenuated in those who resolve their MetS status.
Participants (n = 1,757) from 2 prospective cohort studies were examined as youth (when 9 to 18 years of age) and re-examined 14 to 27 years later. The presence of any 3 components (low high-density lipoprotein cholesterol, high triglycerides, high glucose, high blood pressure, or high body mass index) previously shown to predict adult outcomes defined youth MetS; the harmonized MetS criteria defined adulthood MetS. Participants were classified according to their MetS status at baseline and follow-up and examined for risk of high IMT and T2DM.
Those with MetS in youth and adulthood were at 3.4 times the risk (95% confidence interval: 2.4 to 4.9) of high IMT and 12.2 times the risk (95% confidence interval: 6.3 to 23.9) of T2DM in adulthood compared with those that did not have MetS at either time-point, whereas those that had resolved their youth MetS status by adulthood showed similar risk to those that did not have MetS at either time-point (p > 0.20 for all comparisons).
Although youth with MetS are at increased risk of adult high IMT and T2DM, these data indicate that the resolution of youth MetS by adulthood can go some way to normalize this risk to levels seen in those who have never had MetS.
PubMed ID
23021330 View in PubMed
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Editor's Choice- Diagnosis of type 2 diabetes and prediabetes among patients with acute coronary syndromes.

https://arctichealth.org/en/permalink/ahliterature293537
Source
Eur Heart J Acute Cardiovasc Care. 2017 Dec; 6(8):744-749
Publication Type
Journal Article
Date
Dec-2017
Author
Thorarinn A Bjarnason
Linda B Kristinsdottir
Erna S Oskarsdottir
Steinar O Hafthorsson
Isleifur Olafsson
Sigrun H Lund
Karl Andersen
Author Affiliation
1 Department of Medicine, Division of Cardiology, Landspitali the National University Hospital of Iceland, Reykjavik, Iceland.
Source
Eur Heart J Acute Cardiovasc Care. 2017 Dec; 6(8):744-749
Date
Dec-2017
Language
English
Publication Type
Journal Article
Keywords
Acute Coronary Syndrome - complications - diagnosis - mortality
Blood Glucose - metabolism
Coronary Care Units
Diabetes Mellitus, Type 2 - complications - diagnosis - epidemiology
Electrocardiography
Female
Glucose Tolerance Test
Glycated Hemoglobin A - metabolism
Humans
Iceland - epidemiology
Incidence
Male
Middle Aged
Prediabetic State - complications - diagnosis - epidemiology
Prognosis
ROC Curve
Survival Rate
Abstract
Previously undetected dysglycaemia is common among patients with acute coronary syndromes (ACSs). The aim of this study was to identify the most reliable method of diagnosing type 2 diabetes mellitus (T2DM) and prediabetes in ACS patients.
Patients admitted to the coronary care unit with ACSs and no previous history of T2DM were consecutively included in the study. Glucose metabolism was measured by glycated haemoglobin (HbA1c), fasting plasma glucose (FPG) and 2-hour plasma glucose (2hPG) with a standard oral glucose tolerance test during hospital admission, and this process was repeated 3 months later. In this study, the diagnosis of T2DM required at least two measurements above the diabetes cut-off point according to current American Diabetes Association and World Health Organization criteria.
A total of 250 patients were included in the study. T2DM was diagnosed in 7.2%. The sensitivities for detecting T2DM were 33.3%, 61.1% and 77.8% during admission and 27.8%, 61.1% and 72.2% at follow-up for HbA1c, FPG and 2hPG, respectively. The positive predictive values (PPVs) for diagnosing T2DM were 100%, 91.7% and 51.9% during admission and 71.4%, 91.7% and 65.0% at follow-up for HbA1c, FPG and 2hPG, respectively. The specificities and negative predictive values were high for all methods. By combining all measurements, the sensitivity was 100% and the PPV was 44.2%, while the combination of all HbA1c and FPG measurements provided 88.9% sensitivity and 80.0% PPV.
Diagnosis of T2DM can be reliably carried out by repeated measurements of FPG and HbA1c in ACS patients, with limited added value of an oral glucose tolerance test.
PubMed ID
27625341 View in PubMed
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Left ventricular diastolic function in type 2 diabetes mellitus: prevalence and association with myocardial and vascular disease.

https://arctichealth.org/en/permalink/ahliterature147808
Source
Circ Cardiovasc Imaging. 2010 Jan;3(1):24-31
Publication Type
Article
Date
Jan-2010
Author
Mikael Kjaer Poulsen
Jan Erik Henriksen
Jordi Dahl
Allan Johansen
Oke Gerke
Werner Vach
Torben Haghfelt
Poul Flemming Høilund-Carlsen
Henning Beck-Nielsen
Jacob Eifer Møller
Author Affiliation
Departments of Endocrinology, Nuclear Medicine, and Cardiology, Odense University Hospital, Kløvervaenget 6, Odense, Denmark. mikael.kjaer.poulsen@ouh.regionsyddanmark.dk
Source
Circ Cardiovasc Imaging. 2010 Jan;3(1):24-31
Date
Jan-2010
Language
English
Publication Type
Article
Keywords
Aged
Aorta - physiopathology
Carotid Arteries - physiopathology
Compliance
Coronary Circulation
Denmark - epidemiology
Diabetes Mellitus, Type 2 - complications - diagnosis - epidemiology - physiopathology
Diastole
Dilatation, Pathologic
Echocardiography, Doppler
Female
Heart Atria - ultrasonography
Hemodynamics
Humans
Male
Middle Aged
Myocardial Ischemia - diagnosis - epidemiology - etiology - physiopathology
Myocardial Perfusion Imaging
Peripheral Vascular Diseases - diagnosis - epidemiology - etiology - physiopathology
Predictive value of tests
Prevalence
Prospective Studies
Severity of Illness Index
Systole
Ventricular Dysfunction, Left - diagnosis - epidemiology - etiology - physiopathology
Ventricular Function, Left
Abstract
Although type 2 diabetes mellitus is a risk factor for developing congestive heart failure, the mechanism leading to heart failure is unclear. We examined the prevalence of left ventricular (LV) systolic and diastolic dysfunction in patients with type 2 diabetes mellitus in relation to vascular function and myocardial perfusion.
A prospective observational study of 305 patients with type 2 diabetes mellitus (diabetes duration, 4.5+/-5.3 years) referred consecutively to a diabetes clinic were screened for LV systolic and diastolic function by echocardiography. Vascular function was estimated using noninvasive estimation of pulse pressure, carotid arterial compliance, total arterial compliance, and valvulo-arterial impedance. The prevalences of LV diastolic dysfunction and left atrial (LA) volume index >32 mL/m(2) were 40% and 32%, respectively. The prevalence of myocardial ischemia on myocardial perfusion scintigraphy was more frequent in patients with grade 2 diastolic dysfunction and LA volume index >32 mL/m(2) compared with those having normal or grade 1 diastolic dysfunction (P=0.002) or LA volume index
PubMed ID
19846730 View in PubMed
Less detail

Metabolic syndrome' in a middle-aged Finnish population.

https://arctichealth.org/en/permalink/ahliterature207743
Source
J Cardiovasc Risk. 1997 Aug;4(4):291-5
Publication Type
Article
Date
Aug-1997
Author
M J Vanhala
E A Kumpusalo
T K Pitkäjärvi
J K Takala
Author Affiliation
Pieksämäki District Health Centre, Naarajärvi Health Station, Finland.
Source
J Cardiovasc Risk. 1997 Aug;4(4):291-5
Date
Aug-1997
Language
English
Publication Type
Article
Keywords
Adult
Blood Glucose - metabolism
Blood pressure
Body constitution
Diabetes Mellitus, Type 2 - complications - diagnosis - epidemiology
Female
Finland - epidemiology
Humans
Hypertension - complications - diagnosis - epidemiology
Hypertriglyceridemia - complications - diagnosis - epidemiology
Insulin Resistance
Male
Middle Aged
Obesity - complications - diagnosis - epidemiology
Prevalence
Retrospective Studies
Syndrome
Abstract
To investigate methods for the detection of different clusterings of the insulin-resistant abnormalities consistent with the concept of the 'metabolic syndrome' in clinical practice, and to research the occurrence of these clusters in a middle-aged Finnish population.
We studied a random sample of 207 middle-aged subjects in the city of Tampere, and all 1148 subjects of four middle-aged age groups in Pieksamaki town, in central Finland. Clusterings of the following eight markers of insulin resistance were recorded as the main outcome measures: 1) at least one first-degree relative with non-insulin-dependent diabetes (NIDDM); 2) obesity: body mass index (BMI) > or = 30 kg/m2; 3) central adiposity: waist-to-hip ratio (WHR) > or = 1.00 in men and > or = 0.88 in women; 4) hypertension: systolic blood pressure > or = 160 mmHg or diastolic blood pressure > or = 95 mmHg, or receiving drug treatment for hypertension; 5) hypertriglyceridaemia > or = 1.70 mmol/l; 6) low high-density lipoprotein (HDL) cholesterol: or = 13.0 mU/l.
The metabolic syndrome, defined as a clustering of dyslipidaemia (hypertriglyceridaemia, low HDL cholesterol, or both) and insulin resistance (abnormal glucose tolerance, hyperinsulinaemia, or both) was present in 17% of men and in 8% of women; this sex difference was statistically significant (P
PubMed ID
9477208 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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11 records – page 1 of 2.