Skip header and navigation

Refine By

18 records – page 1 of 2.

Are general practitioners characteristics associated with the quality of type 2 diabetes care in general practice? Results from the Norwegian ROSA4 study from 2014.

https://arctichealth.org/en/permalink/ahliterature294981
Source
Scand J Prim Health Care. 2018 Jun; 36(2):170-179
Publication Type
Journal Article
Date
Jun-2018
Author
Anh Thi Tran
Åsne Bakke
Tore J Berg
Bjørn Gjelsvik
Ibrahimu Mdala
Kjersti Nøkleby
Anam Shakil Rai
John G Cooper
Tor Claudi
Karianne Løvaas
Geir Thue
Sverre Sandberg
Anne K Jenum
Author Affiliation
a Department of General Practice, Institute of Health and Society , University of Oslo , Oslo , Norway.
Source
Scand J Prim Health Care. 2018 Jun; 36(2):170-179
Date
Jun-2018
Language
English
Publication Type
Journal Article
Keywords
Adult
Asia
Blood Glucose - metabolism
Blood pressure
Cross-Sectional Studies
Diabetes Mellitus, Type 2 - blood - therapy
Ethnic Groups
Europe
Female
General practice
General practitioners
Glycated Hemoglobin A - metabolism
Guideline Adherence
Humans
Male
Middle Aged
Norway
Practice Patterns, Physicians'
Quality of Health Care
Abstract
To explore the associations between general practitioners (GPs) characteristics such as gender, specialist status, country of birth and country of graduation and the quality of care for patients with type 2 diabetes (T2DM).
Cross-sectional survey.
The 277 GPs provided care for 10082 patients with T2DM in Norway in 2014. The GPs characteristics were self-reported: 55% were male, 68% were specialists in General Practice, 82% born in Norway and 87% had graduated in Western Europe. Of patients, 81% were born in Norway and 8% in South Asia. Data regarding diabetes care were obtained from electronic medical records and manually verified.
Performance of recommended screening procedures, prescribed medication and level of HbA1c, blood pressure and LDL-cholesterol stratified according to GPs characteristics, adjusted for patient and GP characteristics.
Female GPs, specialists, GPs born in Norway and GPs who graduated in Western Europe performed recommended procedures more frequently than their counterparts. Specialists achieved lower mean HbA1c (7.14% vs. 7.25%, p?
Notes
Cites: Health Aff (Millwood). 2010 Aug;29(8):1461-8 PMID 20679648
Cites: J Intern Med. 2008 Oct;264(4):340-50 PMID 18397244
Cites: J Health Commun. 2013;18 Suppl 1:172-84 PMID 24093354
Cites: BMJ Open. 2012 Jul 12;2(4):null PMID 22798255
Cites: BMC Health Serv Res. 2013 May 20;13:182 PMID 23688317
Cites: N Engl J Med. 2008 Feb 7;358(6):580-91 PMID 18256393
Cites: Diab Vasc Dis Res. 2016 Jul;13(4):268-77 PMID 27190080
Cites: BMJ. 2011 Jun 28;342:d3590 PMID 21712336
Cites: N Engl J Med. 2015 Oct 29;373(18):1720-32 PMID 26510021
Cites: Heart. 2014 Apr;100 Suppl 2:ii1-ii67 PMID 24667225
Cites: Ned Tijdschr Geneeskd. 2008 Nov 1;152(44):2389-94 PMID 19055137
Cites: Diabetes Care. 2005 Jul;28(7):1594-8 PMID 15983306
Cites: PLoS One. 2017 May 1;12(5):e0176135 PMID 28459820
Cites: Diabetes Res Clin Pract. 2009 Mar;83(3):397-401 PMID 19124170
Cites: Eur J Gen Pract. 2014 Jun;20(2):93-9 PMID 24000813
Cites: Diabetes Care. 2004 Feb;27(2):398-406 PMID 14747220
Cites: Diabetes Care. 2010 Mar;33(3):520-5 PMID 20009094
Cites: Rural Remote Health. 2012 Oct;12(4):2265 PMID 23198702
Cites: Swiss Med Wkly. 2003 Oct 11;133(39-40):530-4 PMID 14655053
Cites: BMC Health Serv Res. 2010 May 28;10:145 PMID 20507647
Cites: Med Care. 2004 Sep;42(9):829-39 PMID 15319608
Cites: Arch Intern Med. 2005 Feb 28;165(4):458-63 PMID 15738378
Cites: Scand J Public Health. 2011 May;39(3):239-44 PMID 21270138
Cites: Fam Pract. 2002 Aug;19(4):344-9 PMID 12110552
PubMed ID
29717939 View in PubMed
Less detail

Associations between gestational diabetes mellitus and elevated HbA1c early postpartum in a multi-ethnic population.

https://arctichealth.org/en/permalink/ahliterature288074
Source
Prim Care Diabetes. 2017 Apr;11(2):132-139
Publication Type
Article
Date
Apr-2017
Author
Christin Waage
Anne Karen Jenum
Ibrahimu Mdala
Jens Petter Berg
Kåre Richardsen
Kåre Birkeland
Source
Prim Care Diabetes. 2017 Apr;11(2):132-139
Date
Apr-2017
Language
English
Publication Type
Article
Keywords
Adult
Biomarkers - blood
Case-Control Studies
Diabetes, Gestational - blood - diagnosis - ethnology
Ethnic Groups
European Continental Ancestry Group
Female
Glycated Hemoglobin A - metabolism
Humans
Logistic Models
Minority Groups
Norway - epidemiology
Odds Ratio
Postpartum Period - blood
Pregnancy
Risk factors
Time Factors
Up-Regulation
Abstract
To investigate the prevalence of elevated HbA1c 14 weeks postpartum in different ethnic groups and in women with and without gestational diabetes mellitus (GDM) in the index pregnancy and to explore demographic and biological factors from early pregnancy associated with elevated HbA1c (HbA1c =5.7% (=39mmol/mol)) postpartum.
From a cohort study in Oslo, Norway, we included 570 pregnant women, examined in gestational week 15, 28, and 14 weeks postpartum. The association between elevated HbA1c and demographic and biological factors were assessed by logistic regression analyses.
The prevalence of elevated HbA1c postpartum was 23% in the total population, 15% among Western Europeans and 28% among women with ethnic minority background (p
PubMed ID
27771271 View in PubMed
Less detail

Continued improvement of metabolic control in Swedish pediatric diabetes care.

https://arctichealth.org/en/permalink/ahliterature295534
Source
Pediatr Diabetes. 2018 02; 19(1):150-157
Publication Type
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Date
02-2018
Author
Ulf Samuelsson
Karin Åkesson
Anette Peterson
Ragnar Hanas
Lena Hanberger
Author Affiliation
Division of Pediatrics, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Source
Pediatr Diabetes. 2018 02; 19(1):150-157
Date
02-2018
Language
English
Publication Type
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Child
Diabetes Mellitus - metabolism - therapy
Female
Follow-Up Studies
Glycated Hemoglobin A - metabolism
Humans
Male
Pediatrics - standards
Quality Improvement - statistics & numerical data
Registries
Sweden
Abstract
To prospectively investigate if the grand mean HbA1c and the differences in mean HbA1c between centers in Sweden could be reduced, thereby improving care delivered by pediatric diabetes teams.
We used an 18-month quality improvement collaborative (QIC) together with the Swedish pediatric diabetes quality registry (SWEDIABKIDS). The first program (IQ-1), started in April 2011 and the second (IQ-2) in April 2012; together they encompassed 70% of Swedish children and adolescents with diabetes.
The proportion of patients in IQ-1 with a mean HbA1c 8.7%, 72?mmol/mol) decreased significantly in both QICs, while it increased in the NP group.
The grand mean HbA1c has decreased significantly in Sweden from 2010 to 2014, and QICs have contributed significantly to this decrease. There seems to be a spatial spill-over effect in NP centers.
PubMed ID
27807917 View in PubMed
Less detail

Early glycaemic control for maintaining visual function in type 1 diabetes: The Oulu cohort study of diabetic retinopathy.

https://arctichealth.org/en/permalink/ahliterature296633
Source
Eur J Ophthalmol. 2018 Nov; 28(6):684-689
Publication Type
Journal Article
Date
Nov-2018
Author
Nina Hautala
Mira Siiskonen
Virva Hannula
Kaisu Järvinen
Aura Falck
Author Affiliation
Department of Ophthalmology, PEDEGO Research Unit and Medical Research Center, Oulu University Hospital, Oulu University, Oulu, Finland.
Source
Eur J Ophthalmol. 2018 Nov; 28(6):684-689
Date
Nov-2018
Language
English
Publication Type
Journal Article
Keywords
Adult
Cohort Studies
Contrast Sensitivity - physiology
Diabetes Mellitus, Type 1 - complications
Diabetic Retinopathy - physiopathology
Female
Finland
Glycated Hemoglobin A - metabolism
Humans
Lens, Crystalline - physiopathology
Male
Refractive Errors
Time Factors
Vision Disorders - physiopathology
Visual Acuity - physiology
Young Adult
Abstract
The purpose of this study was to evaluate the visual function and the ophthalmic status of young Finnish adults with long duration of type 1 diabetes in relation to the history of the metabolic control.
A population-based cohort of children with type 1 diabetes examined in the Northern Ostrobothnia hospital district in 1989 (n?=?216) was re-examined 18?years later. High-contrast visual acuity (best-corrected visual acuity), contrast sensitivity, refractive error, lens status, intraocular pressure, stage of diabetic retinopathy and received treatments were evaluated. The metabolic control was reflected by the mean of glycated haemoglobin A1 or glycated haemoglobin A1c values of the years 1983-1989 and 1992-2007, respectively.
In all, 96 men and 76 women age 30?±?3?years with type 1 diabetes duration of 23?±?4?years attended the re-evaluation. About 60% (103/172) had normal best-corrected visual acuity and 3% had low vision. Contrast sensitivity was abnormal in two-thirds. Half had myopia. Four patients had cataract surgery. Low childhood glycated haemoglobin A1 was indicative, and favourable glycated haemoglobin A1c during youth was a significant predictor of better contrast sensitivity and ocular state in adulthood.
The majority of the patients have useful vision, although minor functional impairments are commonly detectable. Long duration of type 1 diabetes in association with non-optimal glycaemic control threatens visual function already at young adulthood. Thus, strong emphasis to control diabetes from onset is important in maintaining good visual function.
PubMed ID
29554811 View in PubMed
Less detail

Early Glycemic Control and Magnitude of HbA1c Reduction Predict Cardiovascular Events and Mortality: Population-Based Cohort Study of 24,752 Metformin Initiators.

https://arctichealth.org/en/permalink/ahliterature287647
Source
Diabetes Care. 2017 Jun;40(6):800-807
Publication Type
Article
Date
Jun-2017
Author
Elisabeth Svensson
Lisbeth M Baggesen
Søren P Johnsen
Lars Pedersen
Helene Nørrelund
Esben S Buhl
Christiane L Haase
Reimar W Thomsen
Source
Diabetes Care. 2017 Jun;40(6):800-807
Date
Jun-2017
Language
English
Publication Type
Article
Keywords
Aged
Blood Glucose - metabolism
Cardiovascular Diseases - complications - drug therapy - mortality
Cohort Studies
Denmark - epidemiology
Diabetes Mellitus, Type 2 - complications - drug therapy - mortality
Female
Follow-Up Studies
Glycated Hemoglobin A - metabolism
Humans
Hypoglycemic agents - therapeutic use
Male
Metformin - therapeutic use
Middle Aged
Prevalence
Proportional Hazards Models
Risk factors
Abstract
We investigated the association of early achieved HbA1c level and magnitude of HbA1c reduction with subsequent risk of cardiovascular events or death in patients with type 2 diabetes who initiate metformin.
This was a population-based cohort study including all metformin initiators with HbA1c tests in Northern Denmark, 2000-2012. Six months after metformin initiation, we classified patients by HbA1c achieved (
PubMed ID
28404659 View in PubMed
Less detail

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
Less detail

Effect of population screening for type 2 diabetes and cardiovascular risk factors on mortality rate and cardiovascular events: a controlled trial among 1,912,392 Danish adults.

https://arctichealth.org/en/permalink/ahliterature292701
Source
Diabetologia. 2017 Nov; 60(11):2183-2191
Publication Type
Controlled Clinical Trial
Journal Article
Date
Nov-2017
Author
Rebecca K Simmons
Simon J Griffin
Daniel R Witte
Knut Borch-Johnsen
Torsten Lauritzen
Annelli Sandbæk
Author Affiliation
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK. rks34@cam.ac.uk.
Source
Diabetologia. 2017 Nov; 60(11):2183-2191
Date
Nov-2017
Language
English
Publication Type
Controlled Clinical Trial
Journal Article
Keywords
Adult
Aged
Blood Glucose - metabolism
Cardiovascular Diseases - etiology - prevention & control
Denmark
Diabetes Mellitus, Type 2 - complications - diagnosis - metabolism
Female
Glycated Hemoglobin A - metabolism
Humans
Male
Mass Screening - methods
Middle Aged
Risk factors
Abstract
Health check programmes for chronic disease have been introduced in a number of countries. However, there are few trials assessing the benefits and harms of these screening programmes at the population level. In a post hoc analysis, we evaluated the effect of population-based screening for type 2 diabetes and cardiovascular risk factors on mortality rates and cardiovascular events.
This register-based, non-randomised, controlled trial included men and women aged 40-69 years without known diabetes who were registered with a general practice in Denmark (n = 1,912,392). Between 2001 and 2006, 153,107 individuals registered with 181 practices participating in the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care (ADDITION)-Denmark study were sent a diabetes risk score questionnaire. Individuals at moderate-to-high risk were invited to visit their GP for assessment of diabetes status and cardiovascular risk (screening group). The 1,759,285 individuals registered with all other general practices in Denmark constituted the retrospectively constructed no-screening (control) group. Outcomes were mortality rate and cardiovascular events (cardiovascular disease death, non-fatal ischaemic heart disease or stroke). The analysis was performed according to the intention-to-screen principle.
Among the screening group, 27,177 (18%) individuals attended for assessment of diabetes status and cardiovascular risk. Of these, 1,533 were diagnosed with diabetes. During a median follow-up of 9.5 years, there were 11,826 deaths in the screening group and 141,719 in the no-screening group (HR 0.99 [95% CI 0.96, 1.02], p = 0.66). There were 17,941 cardiovascular events in the screening group and 208,476 in the no-screening group (HR 0.99 [0.96, 1.02], p = 0.49).
A population-based stepwise screening programme for type 2 diabetes and cardiovascular risk factors among all middle-aged adults in Denmark was not associated with a reduction in rate of mortality or cardiovascular events between 2001 and 2012.
Notes
Cites: Ann Intern Med. 2015 Dec 1;163(11):861-8 PMID 26501513
Cites: Lancet. 2011 Jul 9;378(9786):156-67 PMID 21705063
Cites: BMJ. 2014 Jun 09;348:g3617 PMID 24912589
Cites: Lancet. 2012 Nov 17;380(9855):1741-8 PMID 23040422
Cites: Diabet Med. 1998 Jul;15(7):539-53 PMID 9686693
Cites: Scand J Prim Health Care. 2010 Mar;28(1):47-54 PMID 19929180
Cites: Diabetologia. 2004 Sep;47(9):1566-73 PMID 15365615
Cites: BMJ Open. 2016 Jan 13;6(1):e008840 PMID 26762161
Cites: Diabet Med. 2014 Dec;31(12):1577-85 PMID 25185778
Cites: Cochrane Database Syst Rev. 2012 Oct 17;10:CD009009 PMID 23076952
Cites: Lancet. 2010 Apr 17;375(9723):1365-74 PMID 20356621
Cites: BMJ. 2007 Sep 8;335(7618):490 PMID 17762000
Cites: BMJ. 2007 Sep 8;335(7618):486 PMID 17761995
Cites: Diabet Med. 2010 Sep;27(9):995-1003 PMID 20722672
Cites: Eur Heart J. 2003 Jun;24(11):987-1003 PMID 12788299
Cites: BMJ. 2016 Jan 06;352:h6080 PMID 26740343
Cites: Diabetologia. 2017 Aug 23;:null PMID 28831539
Cites: Diabetes Care. 2004 Mar;27(3):727-33 PMID 14988293
Cites: Prev Med. 2000 Oct;31(4):396-402 PMID 11006065
Cites: Diabetologia. 2016 May;59(5):989-97 PMID 26857739
Cites: Diabetologia. 2011 Feb;54(2):312-9 PMID 20978739
Cites: N Engl J Med. 2008 Oct 9;359(15):1577-89 PMID 18784090
Cites: PLoS One. 2013 Jul 15;8(7):e66454 PMID 23869204
Cites: Scand J Prim Health Care. 2011 Dec;29(4):216-21 PMID 22126220
Cites: Int J Epidemiol. 1999 Apr;28(2):233-40 PMID 10342684
Cites: Int J Obes Relat Metab Disord. 2000 Sep;24 Suppl 3:S6-11 PMID 11063279
Cites: N Engl J Med. 2009 Mar 26;360(13):1320-8 PMID 19297566
Cites: J Med Screen. 2002;9(4):187-90 PMID 12518011
Cites: Diabetes Care. 2015 Aug;38(8):1449-55 PMID 25986661
Cites: BMJ Open. 2015 Dec 18;5(12):e009651 PMID 26685034
PubMed ID
28831535 View in PubMed
Less detail

Estimated glucose disposal rate predicts mortality in adults with type 1 diabetes.

https://arctichealth.org/en/permalink/ahliterature296702
Source
Diabetes Obes Metab. 2018 03; 20(3):556-563
Publication Type
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Date
03-2018
Author
Thomas Nyström
Martin J Holzmann
Björn Eliasson
Ann-Marie Svensson
Ulrik Sartipy
Author Affiliation
Department of Clinical Science and Research, Karolinska Institutet, Stockholm, Sweden.
Source
Diabetes Obes Metab. 2018 03; 20(3):556-563
Date
03-2018
Language
English
Publication Type
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Keywords
Blood Glucose - metabolism
Body mass index
Diabetes Mellitus, Type 1 - blood - mortality
Diabetic Angiopathies - blood - mortality
Female
Glycated Hemoglobin A - metabolism
Humans
Male
Middle Aged
Registries
Risk factors
Survival Analysis
Sweden - epidemiology
Abstract
This study aimed to investigate the association between insulin resistance as determined by the estimated glucose disposal rate (eGDR), and survival in adults with type 1 diabetes (T1D) in Sweden.
Using the Swedish National Diabetes Register, indviduals with T1D were included from January 1, 2005 to December 31, 2012. Outcomes were retrieved from National healthcare registers. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated for the associations between eGDR (mg/kg/min) categorized into
PubMed ID
28884949 View in PubMed
Less detail

Glycemic control and health-related quality of life among older home-dwelling primary care patients with diabetes.

https://arctichealth.org/en/permalink/ahliterature293508
Source
Prim Care Diabetes. 2017 Dec; 11(6):577-582
Publication Type
Journal Article
Date
Dec-2017
Author
Anna-Kaisa Aro
Merja Karjalainen
Miia Tiihonen
Hannu Kautiainen
Juha Saltevo
Maija Haanpää
Pekka Mäntyselkä
Author Affiliation
Institute of Public Health and Clinical Nutrition, General Practice, University of Eastern Finland, Finland; Rantakylä Health Center, Siunsote, Finland. Electronic address: koistine@student.uef.fi.
Source
Prim Care Diabetes. 2017 Dec; 11(6):577-582
Date
Dec-2017
Language
English
Publication Type
Journal Article
Keywords
Activities of Daily Living
Age Factors
Aged
Aged, 80 and over
Aging
Biomarkers - blood
Blood Glucose - metabolism
Cognition
Cross-Sectional Studies
Diabetes Mellitus - blood - diagnosis - psychology - therapy
Female
Finland
Geriatric Assessment
Glycated Hemoglobin A - metabolism
Humans
Independent living
Male
Mental health
Mental Status and Dementia Tests
Mobility Limitation
Predictive value of tests
Primary Health Care
Quality of Life
Risk factors
Self Care - methods
Time Factors
Treatment Outcome
Abstract
To evaluate the health-related quality of life (HRQoL) and functional capacity in relation to glycemic control among older home-dwelling primary care patients.
Electronic patient records were used to identify 527 people over 65 years with diabetes. Of these, 259 randomly selected subjects were invited to a health examination and 172 of them attended and provided complete data. The participants were divided into three groups based on the HbA1c: good (HbA1c57mmol/mol (N=29)) glycemic control. HRQoL was measured with the EuroQol EQ-5D questionnaire. Functional and cognitive capacity and mental well-being were assessed with the Lawton Instrumental Activities of Daily Living (IADL) scale, Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS-15).
EQ-5D scores for good, intermediate and poor glycemic control were 0.78; 0.74 and 0.70, p=0.037. Sub-items of mobility (p=0.002) and self-care were the most affected (p=0.031). Corresponding trend was found for IADL, p=0.008. A significant correlation was found between MMSE scores and HbA1c.
Older primary care home-dwelling patients with diabetes and poorer glycemic control have lower functional capacity and HRQoL, especially in regard to mobility and self-care.
PubMed ID
28754430 View in PubMed
Less detail

Insulin Resistance Predicts Cognitive Decline: An 11-Year Follow-up of a Nationally Representative Adult Population Sample.

https://arctichealth.org/en/permalink/ahliterature287651
Source
Diabetes Care. 2017 Jun;40(6):751-758
Publication Type
Article
Date
Jun-2017
Author
Laura L Ekblad
Juha O Rinne
Pauli Puukka
Hanna Laine
Satu Ahtiluoto
Raimo Sulkava
Matti Viitanen
Antti Jula
Source
Diabetes Care. 2017 Jun;40(6):751-758
Date
Jun-2017
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Apolipoprotein E4 - blood
Blood Glucose - metabolism
Cognition
Cognitive Dysfunction - blood - diagnosis
Cohort Studies
Diabetes Mellitus, Type 2 - blood
Female
Finland
Follow-Up Studies
Glycated Hemoglobin A - metabolism
Humans
Insulin - blood
Insulin Resistance
Linear Models
Male
Middle Aged
Multivariate Analysis
Risk factors
Abstract
The aim of this study was to examine whether insulin resistance, assessed by HOMA of insulin resistance (HOMA-IR), is an independent predictor of cognitive decline.
The roles of HOMA-IR, fasting insulin and glucose, HbA1c, and hs-CRP as predictors of cognitive performance and its change were evaluated in the Finnish nationwide, population-based Health 2000 Health Examination Survey and its 11-year follow-up, the Health 2011 study (n = 3,695, mean age at baseline 49.3 years, 55.5% women). Categorical verbal fluency, word-list learning, and word-list delayed recall were used as measures of cognitive function. Multivariate linear regression analysis was performed and adjusted for previously reported risk factors for cognitive decline.
Higher baseline HOMA-IR and fasting insulin levels were independent predictors of poorer verbal fluency performance (P = 0.0002 for both) and of a greater decline in verbal fluency during the follow-up time (P = 0.004 for both). Baseline HOMA-IR and insulin did not predict word-list learning or word-list delayed recall scores. There were no interactions between HOMA-IR and apolipoprotein E e4 (APOEe4) genotype, hs-CRP, or type 2 diabetes on the cognitive tests. Fasting glucose and hs-CRP levels at baseline were not associated with cognitive functioning.
Our results show that higher serum fasting insulin and insulin resistance predict poorer verbal fluency and a steeper decline in verbal fluency during 11 years in a representative sample of an adult population. Prevention and treatment of insulin resistance might help reduce cognitive decline later in life.
PubMed ID
28381479 View in PubMed
Less detail

18 records – page 1 of 2.