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Abnormal glucose regulation in patients with acute ST- elevation myocardial infarction-a cohort study on 224 patients.

https://arctichealth.org/en/permalink/ahliterature90209
Source
Cardiovasc Diabetol. 2009;8:6
Publication Type
Article
Date
2009
Author
Knudsen Eva C
Seljeflot Ingebjørg
Abdelnoor Michael
Eritsland Jan
Mangschau Arild
Arnesen Harald
Andersen Geir O
Author Affiliation
Center for Clinical Heart Research, Ullevål University Hospital, University of Oslo, Oslo, Norway. evacecilie.knudsen@ulleval.no
Source
Cardiovasc Diabetol. 2009;8:6
Date
2009
Language
English
Publication Type
Article
Keywords
Blood Glucose - analysis
Cohort Studies
Comorbidity
Diabetes Mellitus, Type 2 - blood - diagnosis - epidemiology
Diagnostic Tests, Routine
Fasting - blood
Female
Follow-Up Studies
Glucose Intolerance - blood - diagnosis - epidemiology
Glucose Tolerance Test
Hemoglobin A, Glycosylated - analysis
Humans
Male
Middle Aged
Myocardial Infarction - blood - epidemiology
Norway - epidemiology
Practice Guidelines as Topic
Predictive value of tests
Prevalence
Prospective Studies
Reproducibility of Results
Risk factors
Unnecessary Procedures
Abstract
BACKGROUND: A high prevalence of impaired glucose tolerance and unknown type 2-diabetes in patients with coronary heart disease and no previous diagnosis of diabetes have been reported. The aims of the present study were to investigate the prevalence of abnormal glucose regulation (AGR) 3 months after an acute ST-elevation myocardial infarction (STEMI) in patients without known glucometabolic disturbance, to evaluate the reliability of a 75-g oral glucose tolerance test (OGTT) performed very early after an acute STEMI to predict the presence of AGR at 3 months, and to study other potential predictors measured in-hospital for AGR at 3 months. METHODS: This was an observational cohort study prospectively enrolling 224 STEMI patients treated with primary PCI. An OGTT was performed very early after an acute STEMI and was repeated in 200 patients after 3 months. We summarised the exact agreement observed, and assessed the observed reproducibility of the OGTTs performed in-hospital and at follow up. The patients were classified into glucometabolic categories defined according to the World Health Organisation criteria. AGR was defined as the sum of impaired fasting glucose, impaired glucose tolerance and type 2-diabetes. RESULTS: The prevalence of AGR at three months was 24.9% (95% CI 19.1, 31.4%), reduced from 46.9% (95% CI 40.2, 53.6) when measured in-hospital. Only, 108 of 201 (54%) patients remained in the same glucometabolic category after a repeated OGTT. High levels of HbA1c and admission plasma glucose in-hospital significantly predicted AGR at 3 months (p
PubMed ID
19183453 View in PubMed
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Acarbose for the treatment of type II diabetes: the results of a Canadian multi-centre trial.

https://arctichealth.org/en/permalink/ahliterature214600
Source
Diabetes Res Clin Pract. 1995 Aug;28 Suppl:S167-72
Publication Type
Article
Date
Aug-1995
Author
R G Josse
Author Affiliation
Division of Endocrinology and Metabolism, St. Michael's Hospital, University of Toronto, Ontario, Canada.
Source
Diabetes Res Clin Pract. 1995 Aug;28 Suppl:S167-72
Date
Aug-1995
Language
English
Publication Type
Article
Keywords
Acarbose
Blood Glucose - drug effects - metabolism
Canada
Diabetes Mellitus, Type 2 - drug therapy
Diabetic diet
Female
Hemoglobin A, Glycosylated - analysis
Humans
Hypoglycemic agents - therapeutic use
Insulin - therapeutic use
Male
Metformin - therapeutic use
Middle Aged
Placebos
Sulfonylurea Compounds - therapeutic use
Time Factors
Trisaccharides - therapeutic use
Abstract
The treatment of Type II diabetes (NIDDM) includes an appropriate diet and prudent exercise program. If these measures are insufficient to control the blood sugar, oral agents (sulphonylureas or biguanides) or insulin are added to the therapeutic regimen. Although the diet prescription has undergone some changes and refinements, this approach has been the traditional treatment for NIDDM for nearly 40 years. Recently a new class of oral agents, the alpha-glucosidase inhibitors, has become available. These drugs are competitive inhibitors of the alpha-glucosidase enzymes in the brush border of the bowel wall. They act to slow and delay the rate of carbohydrate absorption, thereby decreasing postprandial hyperglycemia. A recent study was designed to evaluate the long-term efficacy of acarbose, an alpha-glucosidase inhibitor, in improving the glycemic control of patients with NIDDM who were sub-optimally controlled on either diet alone, or diet plus sulphonylurea, metformin or insulin. A total of 354 patients with NIDDM were studied, 77 on diet alone, 83 on metformin, 103 and sulphonylurea and 91 on insulin. Subjects in each treatment stratum were randomized, double-blind to either acarbose or placebo, for 1 year. At baseline and every 3 months thereafter, fasting and postprandial glucose and C-peptide, HbA1c and fasting lipids were measured. Compared to placebo, acarbose treatment resulted in a decrease in mean postprandial glucose in all four strata (19 +/- 0.8 to 15.3 +/- 0.7 mmol/l: P
Notes
Erratum In: Diabetes Res Clin Pract 1995 Sep;29(3):215
PubMed ID
8529510 View in PubMed
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[A comparison of 2 new rapid methods for determination of HbA1C concentration in patients with diabetes mellitus]

https://arctichealth.org/en/permalink/ahliterature48487
Source
Ugeskr Laeger. 1994 Jan 17;156(3):317-21
Publication Type
Article
Date
Jan-17-1994
Author
H B Mortensen
M R Nielsen
E. Christensen
K. Marinelli
B. Petersen
Author Affiliation
Børneafdelingen, Københavns Amts Sygehus i Glostrup.
Source
Ugeskr Laeger. 1994 Jan 17;156(3):317-21
Date
Jan-17-1994
Language
Danish
Publication Type
Article
Keywords
Chromatography, High Pressure Liquid - methods - standards
Comparative Study
Diabetes Mellitus - blood
English Abstract
Evaluation Studies
Hemoglobin A, Glycosylated - analysis
Humans
Immunoassay - methods - standards
Nephelometry and Turbidimetry - methods - standards
Abstract
We have evaluated a new immunoturbidimetric assay (DCA 2000 HbA1c system, Bayer, Denmark) for determination of HbA1c. The aim of the study was to evaluate accuracy, precision and feasibility for the DCA 2000 method when employed in a diabetes centre by a technical assistant and at a general practitioner's by non lab staff. The results were compared with a high performance liquid chromatographic method (HPLC, AUTO A1C, Kyoto Daiichi Kagaku Co., Kyoto, Japan) which is the current laboratory method, and therefore used as reference. Assay time for the DCA 2000 method was nine minutes, while the HbA1c result was displayed within four minutes by HPLC. Blood samples were drawn after informed consent from 118 patients during a period of two months at the out-patient clinic of the Dept. of Paediatrics, Glostrup Hospital (n = 67) and at a general practitioner's (n = 51). Each sample was analyzed twice by each method on two consecutive days. In the HbA1c range from four to 14% (n = 67) the average within-assay precision (SD) for the HPLC method was 0.13%, whilst it was 0.23% for the DCA 2000 method (p 0.07) when carried out by a technical assistant (SD: 0.20%) and by non lab staff (SD: 0.25%). Interbatch variations for HbA1c results investigated with two different batches of reagents within a month were SD 0.30% (HbA1c range: 4.9-5.9%, n = 30) and SD 0.44% (HbA1c range: 10.5-12.1%, n = 30) for these two preparations.(ABSTRACT TRUNCATED AT 250 WORDS)
Notes
Comment In: Ugeskr Laeger. 1994 May 23;156(21):31958066841
PubMed ID
8296425 View in PubMed
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Acoustic-reflex responses in patients with insulin-dependent diabetes mellitus.

https://arctichealth.org/en/permalink/ahliterature48476
Source
Am J Otolaryngol. 1994 Mar-Apr;15(2):109-13
Publication Type
Article
Author
J. Virtaniemi
M. Laakso
J. Nuutinen
S. Karjalainen
E. Vartiainen
Author Affiliation
Department of Otolaryngology, University of Kuopio, Finland.
Source
Am J Otolaryngol. 1994 Mar-Apr;15(2):109-13
Language
English
Publication Type
Article
Keywords
Acoustic Impedance Tests
Adult
Auditory Threshold - physiology
Autonomic Nervous System - physiology
Autonomic Nervous System Diseases - physiopathology
Blood Glucose - analysis
Comparative Study
Diabetes Mellitus, Type 1 - blood - drug therapy - metabolism - physiopathology
Diabetic Angiopathies - physiopathology
Diabetic Neuropathies - physiopathology
Evoked Potentials, Auditory, Brain Stem - physiology
Female
Hemoglobin A, Glycosylated - analysis
Humans
Male
Reaction Time - physiology
Reflex, Acoustic - physiology
Reflex, Stretch - physiology
Research Support, Non-U.S. Gov't
Time Factors
Abstract
PURPOSE: Patients with insulin-dependent diabetes mellitus (IDDM) are especially susceptible to microangiopathic complications such as nephropathy, retinopathy, and neuropathy. Microangiopathic changes are also the most important findings in histopathologic studies of the inner ear and central nervous systems in diabetic subjects. No previous studies have measured acoustic-reflex latencies (ARL) or amplitudes (ARA) in patients with IDDM. ARL and ARA reflect the function of the acoustic-reflex arch. Furthermore, possible changes in the tympanic membrane, ossicular chain, and stapedius muscle may affect the shape of acoustic-reflex. SUBJECTS AND METHODS: Acoustic-reflex thresholds, latencies, and amplitudes were studied in 53 patients with IDDM and 42 randomly selected nondiabetic control subjects, aged between 20 and 40 years, using the Madsen Model ZO 73 Impedance Bridge (Madsen Electronics, Copenhagen, Denmark). Subjects with an abnormal tympanic membrane, conductive hearing loss, and known cause for hearing impairment eg, noise damage, were excluded from the study. RESULTS: There were no differences between control and diabetic subjects in the contralateral acoustic-reflex thresholds. In contrast, patients with IDDM had longer ARLs and decreased ARAs compared with those of control subjects. ARA amplitude had linear correlation with the amplitude of tympanogram, whereas ARL had no linear correlation with auditory brainstem latencies in the same study subjects. Acoustic-reflex responses in insulin-dependent diabetic patients were not associated with the duration of diabetes, metabolic control, microangiopathy, or neuropathy. CONCLUSIONS: Prolonged ARLs and decreased ARAs in patients with insulin-dependent diabetes are probably caused more by the stiff middle ear system than disturbances in the brainstem.
PubMed ID
8179101 View in PubMed
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Affect school and script analysis versus basic body awareness therapy in the treatment of psychological symptoms in patients with diabetes and high HbA1c concentrations: two study protocols for two randomized controlled trials.

https://arctichealth.org/en/permalink/ahliterature279373
Source
Trials. 2016 Apr 27;17(1):221
Publication Type
Article
Date
Apr-27-2016
Author
Eva O Melin
Ralph Svensson
Sven-Åke Gustavsson
Agneta Winberg
Ewa Denward-Olah
Mona Landin-Olsson
Hans O Thulesius
Source
Trials. 2016 Apr 27;17(1):221
Date
Apr-27-2016
Language
English
Publication Type
Article
Keywords
Biomarkers - blood
Body Image
Clinical Protocols
Cognitive Therapy - methods
Diabetes Mellitus, Type 1 - blood - diagnosis - psychology - therapy
Diabetes Mellitus, Type 2 - blood - diagnosis - psychology - therapy
Health Knowledge, Attitudes, Practice
Hemoglobin A, Glycosylated - analysis
Humans
Mind-Body Therapies - methods
Patient Education as Topic
Psychiatric Status Rating Scales
Research Design
Surveys and Questionnaires
Sweden
Time Factors
Treatment Outcome
Up-Regulation
Abstract
Depression is linked with alexithymia, anxiety, high HbA1c concentrations, disturbances of cortisol secretion, increased prevalence of diabetes complications and all-cause mortality. The psycho-educational method 'affect school with script analysis' and the mind-body therapy 'basic body awareness treatment' will be trialled in patients with diabetes, high HbA1c concentrations and psychological symptoms. The primary outcome measure is change in symptoms of depression. Secondary outcome measures are changes in HbA1c concentrations, midnight salivary cortisol concentration, symptoms of alexithymia, anxiety, self-image measures, use of antidepressants, incidence of diabetes complications and mortality.
Two studies will be performed. Study I is an open-labeled parallel-group study with a two-arm randomized controlled trial design. Patients are randomized to either affect school with script analysis or to basic body awareness treatment. According to power calculations, 64 persons are required in each intervention arm at the last follow-up session. Patients with type 1 or type 2 diabetes were recruited from one hospital diabetes outpatient clinic in 2009. The trial will be completed in 2016. Study II is a multicentre open-labeled parallel-group three-arm randomized controlled trial. Patients will be randomized to affect school with script analysis, to basic body awareness treatment, or to treatment as usual. Power calculations show that 70 persons are required in each arm at the last follow-up session. Patients with type 2 diabetes will be recruited from primary care. This study will start in 2016 and finish in 2023. For both studies, the inclusion criteria are: HbA1c concentration =62.5 mmol/mol; depression, alexithymia, anxiety or a negative self-image; age 18-59 years; and diabetes duration =1 year. The exclusion criteria are pregnancy, severe comorbidities, cognitive deficiencies or inadequate Swedish. Depression, anxiety, alexithymia and self-image are assessed using self-report instruments. HbA1c concentration, midnight salivary cortisol concentration, blood pressure, serum lipid concentrations and anthropometrics are measured. Data are collected from computerized medical records and the Swedish national diabetes and causes of death registers.
Whether the "affect school with script analysis" will reduce psychological symptoms, increase emotional awareness and improve diabetes related factors will be tried, and compared to "basic body awareness treatment" and treatment as usual.
ClinicalTrials.gov: NCT01714986.
Notes
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PubMed ID
27121185 View in PubMed
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AHSG tag single nucleotide polymorphisms associate with type 2 diabetes and dyslipidemia: studies of metabolic traits in 7,683 white Danish subjects.

https://arctichealth.org/en/permalink/ahliterature93517
Source
Diabetes. 2008 May;57(5):1427-32
Publication Type
Article
Date
May-2008
Author
Andersen Gitte
Burgdorf Kristoffer Sølvsten
Sparsø Thomas
Borch-Johnsen Knut
Jørgensen Torben
Hansen Torben
Pedersen Oluf
Author Affiliation
Steno Diabetes Center, Niels Steensens Vej 1, NLC2.12, DK-2820 Gentofte, Denmark. gtta@steno.dk
Source
Diabetes. 2008 May;57(5):1427-32
Date
May-2008
Language
English
Publication Type
Article
Keywords
Adaptor Proteins, Signal Transducing - genetics
Blood Proteins - genetics
Denmark
Diabetes Mellitus, Type 2 - complications - genetics
Dyslipidemias - complications - genetics
European Continental Ancestry Group - genetics
Female
Genetic Variation
Hemoglobin A, Glycosylated - analysis
Humans
Insulin Receptor Substrate Proteins
Male
Middle Aged
Obesity - genetics
Polymorphism, Single Nucleotide
Abstract
OBJECTIVE: The gene encoding the alpha2 Heremans-Schmid glycoprotein (AHSG) is a credible biological and positional candidate gene for type 2 diabetes and the metabolic syndrome, and previous attempts to relate AHSG variation with type 2 diabetes and obesity in Swedish and French Caucasians have been largely successful. We related seven frequent AHSG tag single nucleotide polymorphisms to a range of metabolic traits, including type 2 diabetes, obesity, and dyslipidemia. RESEARCH DESIGN AND METHODS: The polymorphisms were genotyped in 7,683 white Danish subjects using Taqman allelic discrimination or chip-based matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, providing a statistical power of >99% to replicate previous findings. Data were analyzed in case-control and haplotype settings, and quantitative metabolic traits were examined for association. Moreover, epistatic effects between AHSG variants and insulin receptor substrate-1 (IRS1) and beta-2-adrenergic receptor polymorphisms were investigated. RESULTS: The -469T>G (rs2077119) and IVS6+98C>T (rs2518136) polymorphisms were associated with type 2 diabetes (P = 0.007 and P = 0.006, respectively, or P(corr) = 0.04 and P(corr) = 0.03, respectively, following correction for multiple hypothesis testing), and in a combined analysis of the present and a previous study -469T>G remained significant (odds ratio 0.90 [95% CI 0.84-0.97]; P = 0.007). Furthermore, two AHSG haplotypes were associated with dyslipidemia (P = 0.003 and P(corr) = 0.009). Thr248Met (rs4917) tended to associate with lower fasting and post-oral glucose tolerance test serum insulin release (P = 0.02, P(corr) = 0.1 for fasting and P = 0.04, P(corr) = 0.2 for area under the insulin curve) and improved insulin sensitivity estimated by the homeostasis model assessment of insulin resistance (9.0 vs. 8.6 mmol x l(-1) x pmol(-1) x l(-1); P = 0.01, P(corr) = 0.06). Indications of epistatic effects of AHSG variants with the IRS1 Gly971Arg polymorphism were observed for fasting serum triglyceride concentrations. CONCLUSIONS: Based on present and previous findings, common variation in AHSG may contribute to the interindividual variation in metabolic traits.
PubMed ID
18316360 View in PubMed
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Allostatic load and clinical risk as related to sense of coherence in middle-aged women.

https://arctichealth.org/en/permalink/ahliterature80436
Source
Psychosom Med. 2006 Sep-Oct;68(5):801-7
Publication Type
Article
Author
Lindfors Petra
Lundberg Olle
Lundberg Ulf
Author Affiliation
Department of Psychology, Stockholm University and Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, SE 106 91 Stockholm, Sweden. pls@psychology.su.se
Source
Psychosom Med. 2006 Sep-Oct;68(5):801-7
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Adult
Aging - psychology
Attitude
Blood pressure
Cholesterol - blood
Cholesterol, HDL - blood
Chronic Disease - epidemiology
Disease Susceptibility
Follow-Up Studies
Health status
Hemoglobin A, Glycosylated - analysis
Humans
Menopause
Peak Expiratory Flow Rate
Personal Satisfaction
Physical Examination
Questionnaires
Risk
Stress - epidemiology - psychology
Stress, Psychological - epidemiology - physiopathology - psychology
Sweden - epidemiology
Waist-Hip Ratio
Abstract
OBJECTIVE: To investigate how physiologic dysregulation, in terms of allostatic load and clinical risk, respectively, relates to sense of coherence (SOC) in women with no previously diagnosed pathology. METHODS: At baseline, 200 43-year-old women took part in a standardized medical health examination and completed a 3-item measure of SOC, which they completed again 6 years later. According to data from the medical examination, two different measures of physiologic dysregulation were calculated: a) a measure of allostatic load based on empirically derived cut points and b) a measure of clinical risk based on clinically significant cut points. RESULTS: In line with the initial hypotheses, allostatic load was found to predict future SOC, whereas clinical risk did not. In addition to baseline SOC and nicotine consumption, allostatic load was strongly associated with a weak SOC at the follow-up. CONCLUSIONS: The better predictive value of allostatic load to clinical risk indicates that focusing solely on clinical risk obscures patterns of physiologic dysregulation that influence future SOC.
PubMed ID
17012536 View in PubMed
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Alveolar bone loss in type 1 diabetic subjects.

https://arctichealth.org/en/permalink/ahliterature47825
Source
J Clin Periodontol. 2000 Aug;27(8):567-71
Publication Type
Article
Date
Aug-2000
Author
T. Tervonen
K. Karjalainen
M. Knuuttila
S. Huumonen
Author Affiliation
Oral and Maxillofacial Department, Oulu University Hospital, Finland. tellervo.tervonen@oulu.fi
Source
J Clin Periodontol. 2000 Aug;27(8):567-71
Date
Aug-2000
Language
English
Publication Type
Article
Keywords
Adult
Alveolar Bone Loss - etiology - metabolism - radiography
Analysis of Variance
Case-Control Studies
Diabetes Mellitus, Type 1 - complications
Hemoglobin A, Glycosylated - analysis
Humans
Statistics, nonparametric
Abstract
AIM, BACKGROUND: The aim of this study was to assess the degree of marginal alveolar bone loss in a group of young subjects with type 1 diabetes mellitus (DM) (n=35, age range 24-36 years) and age-matched non-diabetic control subjects (n=10). METHOD: The diabetic group was divided into 3 subgroups (D1, D2, D3) according to the severity of the diabetic state. The level of alveolar bone was measured on panoramic radiographs of maxillary and mandibular molars as the % of the distance between the cemento-enamel junction (CEJ) and the bone crest along the total length of the root. All mesial and distal sites with a distance of > 15% (BL>15%) were picked, and calculations were performed using the individual %s of sites with BL> 15%. RESULTS: Based on the present findings, we conclude that type 1 DM has a modifying effect on marginal loss of alveolar bone. A clear trend towards increased marginal bone loss was seen in the subjects with complicated DM (D3). The subjects with good metabolic control and no complications of DM (D1) are no more susceptible to marginal bone loss than non-diabetic controls of the same age. CONCLUSIONS: The present findings confirm our previous results on increased loss of periodontal support in subjects with complicated DM already at an early age.
PubMed ID
10959782 View in PubMed
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Analytical performance specifications based on how clinicians use laboratory tests. Experiences from a post-analytical external quality assessment programme.

https://arctichealth.org/en/permalink/ahliterature270020
Source
Clin Chem Lab Med. 2015 May;53(6):857-62
Publication Type
Article
Date
May-2015
Author
Geir Thue
Sverre Sandberg
Source
Clin Chem Lab Med. 2015 May;53(6):857-62
Date
May-2015
Language
English
Publication Type
Article
Keywords
Blood Glucose - analysis
Blood Sedimentation
Clinical Laboratory Techniques - standards
Creatinine - blood - urine
Diabetes Mellitus, Type 2 - diagnosis
Glomerular Filtration Rate
Hemoglobin A, Glycosylated - analysis
Humans
International Normalized Ratio
Norway
Quality Control
Reference Values
Serum Albumin - analysis
Abstract
Analytical performance specifications can be based on three different models: the effect of analytical performance on clinical outcome, based on components of biological variation of the measurand or based on state-of-the-art. Models 1 and 3 may to some degree be combined by using case histories presented to a large number of clinicians. The Norwegian Quality Improvement of Primary Care Laboratories (Noklus) has integrated vignettes in its external quality assessment programme since 1991, focusing on typical clinical situations in primary care. Haemoglobin, erythrocyte sedimentation rate (ESR), HbA1c, glucose, u-albumin, creatinine/estimated glomerular filtration rate (eGFR), and Internationl Normalised Ratio (INR) have been evaluated focusing on critical differences in test results, i.e., a change from a previous result that will generate an "action" such as a change in treatment or follow-up of the patient. These critical differences, stated by physicians, can translate into reference change values (RCVs) and assumed analytical performance can be calculated. In general, assessments of RCVs and therefore performance specifications vary both within and between groups of doctors, but with no or minor differences regarding specialisation, age or sex of the general practitioner. In some instances state-of-the-art analytical performance could not meet clinical demands using 95% confidence, whereas clinical demands were met using 80% confidence in nearly all instances. RCVs from vignettes should probably not be used on their own as a basis for setting analytical performance specifications, since clinicians seem "uninformed" regarding important principles. They could rather be used as a background for focus groups of "informed" physicians in discussions of performance specifications tailored to "typical" clinical situations.
PubMed ID
25883204 View in PubMed
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Antihyperglycaemic treatment of type 2 diabetes: results from a national diabetes register.

https://arctichealth.org/en/permalink/ahliterature163570
Source
Diabetes Metab. 2007 Sep;33(4):269-76
Publication Type
Article
Date
Sep-2007
Author
B. Eliasson
K. Eeg-Olofsson
J. Cederholm
P M Nilsson
S. Gudbjörnsdóttir
Author Affiliation
Department of Medicine, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden. bjorn.eliasson@gu.se
Source
Diabetes Metab. 2007 Sep;33(4):269-76
Date
Sep-2007
Language
English
Publication Type
Article
Keywords
Adult
Aged
Blood Glucose - metabolism
Body mass index
Coronary Disease - prevention & control
Cross-Sectional Studies
Diabetes Mellitus, Type 2 - complications - drug therapy - epidemiology - physiopathology
Diabetic Angiopathies - prevention & control
Female
Hemoglobin A, Glycosylated - analysis
Humans
Hypoglycemic agents - therapeutic use
Lipids - blood
Longitudinal Studies
Male
Middle Aged
Registries
Sweden - epidemiology
Abstract
To describe clinical characteristics and antihyperglycemic treatment patterns in patients with varying duration of diabetes.
We performed a cross-sectional survey of 61890 type 2 diabetic (DM2) patients from the Swedish National Diabetes Register (NDR) in 2004. We also analysed the effect of types of treatment and risk factors on glycaemic control in a longitudinal cohort study from 1996 to 2004. HbA(1c), risk factors and treatments were determined locally in primary care as well as hospital outpatient clinics.
Insulin was frequently used in DM2 patients with long duration of diabetes, although the mean HbA(1c) increased and only a few in this group reached HbA(1c) 1%) from 1996 to 2004 were more often treated with insulin than with oral hypoglycaemic agents (OHA). During this period, the HbA(1c) levels leading to additional treatment decreased. A low BMI, decreasing BMI and not smoking were predictors of good long-term metabolic control. Hypertension and hyperlipidaemia were frequent in both newly diagnosed DM2 patients and in patients with a long duration of diabetes.
Insulin treatment was frequently used, particularly in patients with a long duration of DM2. The glycaemic control, which usually deteriorates over time, did not reach the recommended goal, despite the fact that complementary treatment was added at lower HbA(1c) levels in 2003 than in 1996. High frequencies of hypertension, hyperlipidaemia and high 10-year risks of coronary heart disease necessitate intensified risk factor control in the future.
PubMed ID
17499541 View in PubMed
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339 records – page 1 of 34.