To evaluate the data quality in the Danish National Registry of Patients (DNRP) and the Prescription Registry in the country of Northern Jutland (487,000 inhabitants) concerning insulin dependent diabetes mellitus (IDDM) and insulin treated diabetes mellitus, a comparison between data in the two registries was made. From the Regional Hospital Registry in the County of Northern Jutland, containing discharge diagnoses from all admissions to hospitals in the county, we identified all patients with the IDDM diagnosis between 1987 and 1993. From the Regional Prescription Registry all insulin prescriptions taken up at pharmacies in the county in 1993 were identified. All persons were identified by their individual identification number (CPR-number), and a record linkage between the two data sources was made. The predictive value of an IDDM-registration in the DNRP was 96% and the corresponding completeness 91%. In the Prescription Registry the completeness was 96%. Both registries seem to be valuable study bases for epidemiological research in diabetes mellitus.
PURPOSE: To describe and compare the pattern of antihypertensive drug prescriptions during different time periods. METHODS: Antihypertensive prescriptions were registered in all patients who underwent an annual follow-up during 1998 (n = 984), 1992-1993 (n = 924), and 1981 (n = 689), at the hypertension outpatient clinic in primary health care, Skara, Sweden. RESULTS: From 1981 to 1998 the total prescriptions of thiazides declined from 61 to 10% (p
During the years 1979 to 1981 a population-based case-control study of bladder cancer including papillomas was performed in Greater Copenhagen. After exclusions some 388 patients (290 males; 98 females) and an age- and sex-matched group of 787 controls (592 males; 195 females) remained for analysis. Controls were selected at random from the general population of the study area. All persons were interviewed concerning use of artificial sweeteners in addition to their exposure to a number of other known or suspected risk factors for bladder cancer. Fifty-five male bladder cancer patients (19.4%) and 150 controls (25.7%) had at some time used artificial sweeteners regularly. Among females 27.1% of cases and 25.9% of controls regularly used sweeteners. In neither sex was the relative risk significantly increased in users compared with non-users of artificial sweeteners. The relative risk of 0.78 in the two sexes combined was not significantly different from 1.0 (95% C.I.: 0.58-1.05). There was no indication of a regular increase in risk with increasing daily consumption of table-top sweeteners nor was there any indication of an increase in risk with a duration of regular use of artificial sweeteners. Taking into account a possible latency period between first regular use and bladder cancer development did not change the finding of an absence of association between use of artificial sweeteners and the risk of bladder cancer. Neither saccharine nor cyclamate users had an increased risk of bladder cancer. This population-based case-control investigation provides further evidence that it is highly unlikely that the consumption of artificial sweeteners has contributed to current bladder cancer rates in man.
The object was to analyze, in a nationwide survey, the incidence and course of hereditary hemochromatosis in relation to the degree of iron overload and the presence of organ damage. The study included 179 Danish Caucasian patients with clinically overt hemochromatosis diagnosed between 1948 and 1985. A cohort of 158 patients was followed for a median of 8.5 years (range: 0.2-29.5). From 1951 to 1975, the yearly relative incidence rate was constant: 0.58/100,000 persons >20 years of age. From 1981 to 1985, the yearly relative incidence rate rose to 1.40/100,000 persons >20 years of age. Survival was reduced in the entire series when compared with a matched control population ( p
In this report are examined the patterns of control of diabetes mellitus achieved by practicing family physicians in small communities in the Pacific Northwest and Alaska. The diabetic patients under study appear to be broadly similar to patients in tertiary care settings, where most studies of diabetes care have been carried out. Motivated, competent family physicians, knowledgeable about tight control of diabetes, appear to have considerable difficulty in maintaining even modest levels of biochemical control. Goals in this study for fasting plasma glucose levels for patients with insulin-dependent diabetes mellitus (IDDM) averaged between 120 and 160 mg/100 ml. Glucose levels actually achieved ranged up to 360 mg/100 ml. A similar though lesser discrepancy was noted for patients with non-insulin-dependent diabetes mellitus (NIDDM), with achieved levels ranging up to 270 mg/100 ml fasting plasma glucose. There were wide individual differences among physicians in management styles and treatment policy, including wide discrepancies in emphasis on diet, use of oral hypoglycemic agents, and insulin use. This diversity is felt to merit further investigation. Collaborative studies of this type with community based physicians are feasible and academically rewarding. Significant research questions can be addressed and answered.U
A prescription inventory was performed over a period of 3 months in all pharmacies in Sweden's northernmost province. Norrbotten, in order to assess the prevalence of diabetes treated with insulin and oral anti-diabetic agents. A total of 4869 prescriptions were collected from 3482 individuals, of whom 1746 (50.1%) were men. The prevalence of drug-treated diabetes was thus 13.27/1000 inhabitants (95% confidence interval (CI) 12.8-13.7) in the province. Nearly half (47.9%) of all drug-treated diabetics were treated with insulin and the majority (74%) were over 55 years of age, with only 449 (13%) being less than 40 years old. The prevalence of diabetes was highest in individuals aged 75-84 years; in this age group it was 55.47/1000 (95% CI 50.9-58.7). There was considerable regional variation in the prevalence of diabetes in Norrbotten, with a mean prevalence of 23.84/1000 (95% CI 22.1-25.6) in the municipalities in the Torneå Valley, compared to 13.08/1000 (95% CI 1.19-1.28) for the remainder of Norrbotten. While there was no difference in the prevalence of drug-treated diabetes between men and women in the province as a whole, a slightly higher prevalence was found in women (27.41 vs. 24.73/1000) in the Torneå Valley. The prevalence of diabetes mellitus in individuals over 40 years of age was 36.62/1000 (95% CI 3.73-4.36) in The Torneå Valley, 24.38/1000 (95% CI 22.8-24.7) in the remainder of Norrbotten, and 27.88/1000 (95% CI 2.50-2.68) in the province as a whole. The estimated prevalence of diabetes mellitus in Norrbotten, including patients treated by diet alone, was of the order of 20.21/1000, with a prevalence of 40.00/1000 in subjects over the age of 40 years. Thus the prevalence of diabetes appears to be higher in the Torneå Valley than in the rest of Norrbotten, while it is apparently lower than has been reported in North Finland.
A 7-year follow-up study is reported on the prevalent population of all insulin-treated diabetic patients (n = 1499) as of 1 July 1973 in the Funen County, Denmark. The analysis of mortality was based on data from 395 dead and the remaining 1104 living patients. Males had a significantly higher mortality than females and a lower age at onset was associated with a significantly higher mortality. An analysis of the causes of death revealed a higher than expected number of deaths in all categories studied, although the excess mortality was highest for diabetes mellitus itself and cardiovascular diseases. Diabetes mellitus was not notified on 15% of the death certificates, and this under-reporting varied according to duration of the disease and place of death. It is concluded that studies based solely on death certificates will underestimate the mortality of diabetes mellitus, and that further longitudinal studies of well-defined, population-based patient groups are needed to evaluate the determinants of mortality in diabetes.
The study aimed at tracing the population of insulin-treated diabetics living in the Funen County, Denmark (approximately 450000 inhabitants) on 1 July 1973. It was based on a recording of insulin prescriptions among all prescriptions handled by the pharmacies in Funen County during a five-month period. Through information from medical records and public registries the verification of the diagnosis and the identity of the insulin prescription holders were checked, and it is estimated that the completeness of the study material was above 98%. Age- and sex-specific prevalence rates of insulin-treated diabetes mellitus were calculated. The overall prevalence rate for males was 3.6 per 1,000 and that for females 3.3 per 1,000.
OBJECTIVE: To measure the risk factors and treatment profile of diabetes patients treated in primary health care (PHC) in order to evaluate potential gender differences. DESIGN: Cross-sectional survey of consecutive diabetes patients. SETTING: 229 PHC centres in Sweden. SUBJECTS: 5082 men and 4293 women with diabetes were investigated (1998-2001). MAIN OUTCOME MEASURES: Glycaemic control (HbA1c), blood pressure, lipid levels, prevalence of left ventricular hypertrophy and microalbuminuria. Proportions of patients with previous ischaemic heart disease (IHD) and specific drug treatment. RESULTS: Male patients generally had better blood pressure (
OBJECTIVE. To determine the prevalence of insulin-treated diabetes mellitus in Funen County, Denmark as of 1 July 1987 and compare the findings with those of a similar study from 1973. DESIGN. The population was identified by insulin prescriptions collected during a 1 year period. The identity of the prescription holders, the diagnosis and the date of diagnosis were verified from medical records and public registers. RESULTS. The estimated degree of ascertainment of the material is 0.95-0.97. The prevalence rates (per 1000 of the population) of insulin-treated diabetes mellitus as of 1 July 1987 are: 4.74 (95% Cl 4.66-4.82) for all cases, 2.08 (95% Cl 2.01-2.15) for the group with onset of diabetes before age 30 years and 2.66 (95% Cl 2.59-2.73) for the group with onset after age 30 years. These figures correspond to increases of 39, 26 and 51% (P