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Adult stature and diabetes complications in patients with type 1 diabetes: the FinnDiane Study and the diabetes control and complications trial.

https://arctichealth.org/en/permalink/ahliterature150600
Source
Diabetes. 2009 Aug;58(8):1914-20
Publication Type
Article
Date
Aug-2009
Author
Johan Wadén
Carol Forsblom
Lena M Thorn
Markku Saraheimo
Milla Rosengård-Bärlund
Outi Heikkilä
Kustaa Hietala
Ken Ong
Nicholas Wareham
Per-Henrik Groop
Author Affiliation
Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, Finland.
Source
Diabetes. 2009 Aug;58(8):1914-20
Date
Aug-2009
Language
English
Publication Type
Article
Keywords
Adult
Age of Onset
Albuminuria - epidemiology
Body Height
Cardiovascular Diseases - epidemiology
Cross-Sectional Studies
Diabetes Mellitus, Type 1 - complications
Diabetic Angiopathies - epidemiology
Diabetic Nephropathies - epidemiology
Diabetic Retinopathy - epidemiology
Female
Finland
Hemoglobin A, Glycosylated - metabolism
Humans
Male
Middle Aged
Abstract
Short adult stature has previously been associated with cardiovascular disease, but its relationship with the microvascular complications of diabetes is uncertain. Therefore, we evaluated the association between adult stature and prevalence and incidence of diabetic microvascular complications.
This cross-sectional and longitudinal study comprises 3,968 adult patients with type 1 diabetes from the Finnish Diabetic Nephropathy (FinnDiane) Study and 1,246 adult patients from the Diabetes Control and Complications Trial (DCCT). In FinnDiane, diabetic nephropathy was defined as urinary albumin excretion > or = 300 mg/24 h, dialysis, or renal transplantation. Retinopathy was divided into background and proliferative (laser-treated) retinopathy. In the DCCT, original nephropathy (class 1-6) and retinopathy (Early Treatment of Diabetic Retinopathy Study) classifications were used.
In the FinnDiane study, patients in the lowest quartile of adult height had increased risks of prevalent diabetic nephropathy (odds ratio [OR] 1.71, 95% CI 1.44-2.02) and prevalent laser-treated retinopathy (1.66, 1.43-1.93) compared with other patients. Similarly, in the DCCT, patients in the lowest quartile of adult height had increased risks of incident diabetic nephropathy class 4-6 (hazard ratio 2.70, 95% CI 1.59-4.59) and incident proliferative retinopathy (2.06, 1.15-3.71). In the FinnDiane study, the associations were largely explained by childhood exposure to diabetes. However, in the DCCT, where a greater proportion of patients had diabetes onset >18 years, the association with nephropathy was independent of childhood diabetes exposure.
Short adult stature is associated with microvascular complications in patients with type 1 diabetes. These findings are compatible with either childhood diabetes exposure or "common soil" or both as potential explanations.
Notes
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PubMed ID
19491208 View in PubMed
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Children and adolescents with type 1 diabetes and high HbA1c -- a neurodevelopmental perspective.

https://arctichealth.org/en/permalink/ahliterature117640
Source
Acta Paediatr. 2013 Apr;102(4):410-5
Publication Type
Article
Date
Apr-2013
Author
Charlotte Nylander
Henri Toivonen
Salmir Nasic
Ulf Söderström
Ylva Tindberg
Elisabeth Fernell
Author Affiliation
Department of Women's and Children's Health, Uppsala University, Sweden. charlotte.nylander@kbh.uu.se
Source
Acta Paediatr. 2013 Apr;102(4):410-5
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Age Factors
Age of Onset
Child
Child, Preschool
Developmental Disabilities - diagnosis - epidemiology - etiology
Diabetes Complications - epidemiology
Diabetes Mellitus, Type 1 - metabolism
Early Diagnosis
Executive Function - physiology
Female
Hemoglobin A, Glycosylated - metabolism
Humans
Learning Disorders - diagnosis - epidemiology - etiology
Male
Memory Disorders - diagnosis - epidemiology - etiology
Motor Skills Disorders - diagnosis - epidemiology - etiology
Population Surveillance
Questionnaires
Sweden
Abstract
To examine the association between neurodevelopmental problems and high HbA1c among paediatric patients with type 1 diabetes.
A population-based study was performed among patients with type 1 diabetes (5-16 years) in two Swedish counties (n = 233). The Five to Fifteen (FTF) questionnaire targeted neurodevelopmental qualities. Scores above the 90th percentile in the various domains are considered as definitive problems and scores above the 75th percentile as mild. FTF scores were compared with regard to HbA1c =73 mmol/mol and >73 mmol/mol (8.0%).
The response rate was 190 (82%). Neurodevelopmental problems were not overrepresented among patients in general. Memory and learning problems were associated with HbA1c >73 mmol/mol (p = 0.01). This correlation was especially seen in adolescents (12-16 years) where mild executive problems (adjOR 3.1), definite memory problems (adjOR 5.0) and definite learning problems (adjOR 5.0) were associated with HbA1c >73 mmol/mol after adjustment for gender, diabetes duration and age of onset.
Our findings that high HbA1c is more common in adolescent diabetes patients with neurodevelopmental problems generate the hypothesis that these problems might precede poor metabolic control. If so, early detection of neurodevelopmental problems would allow individually tailored treatment that may improve metabolic control and prevent complications.
PubMed ID
23278767 View in PubMed
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Clinical characteristics at onset of Type 1 diabetes in children diagnosed between 1977 and 2001 in the south-east region of Sweden.

https://arctichealth.org/en/permalink/ahliterature29786
Source
Diabetes Res Clin Pract. 2005 Apr;68(1):49-55
Publication Type
Article
Date
Apr-2005
Author
Ulf Samuelsson
Lars Stenhammar
Author Affiliation
Department of Molecular and Clinical Medicine, Diabetes Research Centre and Division of Pediatrics, Linköping University, S-58185 Linköping, Sweden. ulf.samuelsson@lio.se
Source
Diabetes Res Clin Pract. 2005 Apr;68(1):49-55
Date
Apr-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Age Distribution
Age of Onset
Blood glucose
Child
Child, Preschool
Diabetes Mellitus, Type 1 - epidemiology - metabolism
Female
Hemoglobin A, Glycosylated - metabolism
Humans
Hydrogen-Ion Concentration
Infant
Infant, Newborn
Ketones - urine
Male
Research Support, Non-U.S. Gov't
Sweden - epidemiology
Abstract
To survey clinical characteristics at diagnosis for children diagnosed with Type 1 diabetes during 25 years in the south-east part of Sweden we included all 1903 children
PubMed ID
15811565 View in PubMed
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Early glycemic control, age at onset, and development of microvascular complications in childhood-onset type 1 diabetes: a population-based study in northern Sweden.

https://arctichealth.org/en/permalink/ahliterature30424
Source
Diabetes Care. 2004 Apr;27(4):955-62
Publication Type
Article
Date
Apr-2004
Author
Maria Svensson
Jan W Eriksson
Gisela Dahlquist
Author Affiliation
Department of Medicine, Umeå University Hospital, Umeå, Sweden. maria.svensson@medicin.umu.se
Source
Diabetes Care. 2004 Apr;27(4):955-62
Date
Apr-2004
Language
English
Publication Type
Article
Keywords
Adolescent
Age of Onset
Child
Child, Preschool
Diabetes Mellitus, Type 1 - blood - complications - drug therapy - epidemiology
Diabetic Angiopathies - etiology
Diabetic Nephropathies - etiology
Female
Hemoglobin A, Glycosylated - metabolism
Humans
Hypoglycemic agents - therapeutic use
Infant
Infant, Newborn
Insulin - therapeutic use
Male
Multivariate Analysis
Research Support, Non-U.S. Gov't
Time Factors
Abstract
OBJECTIVE: The aim of this work was to study the impact of glycemic control (HbA(1c)) early in disease and age at onset on the occurrence of incipient diabetic nephropathy (MA) and background retinopathy (RP) in childhood-onset type 1 diabetes. RESEARCH DESIGN AND METHODS: All children, diagnosed at 0-14 years in a geographically defined area in northern Sweden between 1981 and 1992, were identified using the Swedish Childhood Diabetes Registry. From 1981, a nationwide childhood diabetes care program was implemented recommending intensified insulin treatment. HbA(1c) and urinary albumin excretion were analyzed, and fundus photography was performed regularly. Retrospective data on all 94 patients were retrieved from medical records and laboratory reports. RESULTS: During the follow-up period, with a mean duration of 12 +/- 4 years (range 5-19), 17 patients (18%) developed MA, 45 patients (48%) developed RP, and 52% had either or both complications. A Cox proportional hazard regression, modeling duration to occurrence of MA or RP, showed that glycemic control (reflected by mean HbA(1c)) during the follow-up was significantly associated with both MA and RP when adjusted for sex, birth weight, age at onset, and tobacco use as potential confounders. Mean HbA(1c) during the first 5 years of diabetes was a near-significant determinant for development of MA (hazard ratio 1.41, P = 0.083) and a significant determinant of RP (1.32, P = 0.036). The age at onset of diabetes significantly influenced the risk of developing RP (1.11, P = 0.021). Thus, in a Kaplan-Meier analysis, onset of diabetes before the age of 5 years, compared with the age-groups 5-11 and >11 years, showed a longer time to occurrence of RP (P = 0.015), but no clear tendency was seen for MA, perhaps due to lower statistical power. CONCLUSIONS: Despite modern insulin treatment, >50% of patients with childhood-onset type 1 diabetes developed detectable diabetes complications after approximately 12 years of diabetes. Inadequate glycemic control, also during the first 5 years of diabetes, seems to accelerate time to occurrence, whereas a young age at onset of diabetes seems to prolong the time to development of microvascular complications.
PubMed ID
15047655 View in PubMed
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Higher age at onset of type 1 diabetes increases risk of macular oedema.

https://arctichealth.org/en/permalink/ahliterature120742
Source
Acta Ophthalmol. 2013 Dec;91(8):709-15
Publication Type
Article
Date
Dec-2013
Author
Kustaa Hietala
Carol Forsblom
Paula Summanen
Per-Henrik Groop
Author Affiliation
Folkhälsan Institute of Genetics, Folkhälsan Research Center, Helsinki, FinlandDepartment of Ophthalmology, Helsinki University Central Hospital, Helsinki, FinlandDivision of Nephrology, Department of Medicine, Helsinki University Central Hospital, Helsinki, FinlandThe Baker IDI Heart and Diabetes Institute, Melbourne, Vic., Australia.
Source
Acta Ophthalmol. 2013 Dec;91(8):709-15
Date
Dec-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Age of Onset
Aging - physiology
Child
Child, Preschool
Diabetes Mellitus, Type 1 - epidemiology - physiopathology
Diabetic Retinopathy - epidemiology - physiopathology
Female
Finland - epidemiology
Hemoglobin A, Glycosylated - metabolism
Humans
Incidence
Infant
Macular Edema - epidemiology - physiopathology
Male
Risk factors
Young Adult
Abstract
To investigate whether age at onset of type 1 diabetes is a risk factor for clinically significant macular oedema (CSME).
A sample of 1354 patients with a mean duration of diabetes 24.6 ± 11.6 years was drawn from the FinnDiane Study population and divided into age at onset groups 0-4 (n = 184), 5-14 (n = 662) and 15-40 years (n = 508). Type 1 diabetes was defined as age at onset =40 years, C-peptide negativity and insulin treatment initiated within 1 year of diagnosis. Retinopathy status was assessed from fundus photographs and stereoscopic fundus examinations and graded with the ETDRS scale.
After 30 years of diabetes, the estimated cumulative incidences of CSME were 17% (95% CI 11-26) in age at onset group 0-4 years, 27% (95% CI 23-32) in age at onset group 5-14 years and 34% (95% CI 27-41) in age at onset group 15-40 years (p = 0.002, Gray's test). In a competing risks regression model, adjusted for covariates selected with Bayesian information criteria, age at onset 5-14 years (HR 1.89 [95% CI 1.22-2.91], p = 0.004), and age at onset 15-40 years (HR 3.72 [95% CI 2.35-5.89], p
PubMed ID
22973826 View in PubMed
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Incidence of blindness and visual impairment in diabetic patients participating in an ophthalmological control and screening programme.

https://arctichealth.org/en/permalink/ahliterature34538
Source
Acta Ophthalmol Scand. 1996 Dec;74(6):533-8
Publication Type
Article
Date
Dec-1996
Author
M. Henricsson
M. Tyrberg
A. Heijl
L. Janzon
Author Affiliation
Department of Ophthalmology, Helsingborg Hospital, Sweden.
Source
Acta Ophthalmol Scand. 1996 Dec;74(6):533-8
Date
Dec-1996
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age of Onset
Aged
Blindness - diagnosis - epidemiology - etiology
Child
Diabetes Complications
Diabetes Mellitus - blood
Diabetic Retinopathy - complications - diagnosis - physiopathology
Female
Follow-Up Studies
Hemoglobin A, Glycosylated - metabolism
Humans
Hyperglycemia - blood - complications
Incidence
Male
Middle Aged
Multivariate Analysis
Ophthalmology - methods
Research Support, Non-U.S. Gov't
Retrospective Studies
Sweden - epidemiology
Vision Disorders - diagnosis - epidemiology - etiology
Vision Screening
Visual acuity
Abstract
We studied the incidence of blindness and visual impairment in patients who were enrolled in a photographic control- and screening program for diabetic retinopathy. The study cohort consisted of 2133 patients examined between January 1990 and December 1992 and followed until October 1st 1995. The occurrence of blindness (visual acuity or = 8.5%, were associated with a 65% increase in risk of blindness/visual impairment (95% confidence interval 14-130%). Retinopathy was the major cause of blindness and visual impairment in patients with diabetes. The study revealed a low incidence of blindness, which is in line with recent reports. Control of hyperglycaemia may be of value for the prevention of visual loss.
PubMed ID
9017036 View in PubMed
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The influence of glucagon on postprandial hyperglycaemia in children 5 years after onset of type 1 diabetes.

https://arctichealth.org/en/permalink/ahliterature268407
Source
Diabetologia. 2015 Apr;58(4):828-34
Publication Type
Article
Date
Apr-2015
Author
Siri Fredheim
Marie-Louise M Andersen
Sven Pörksen
Lotte B Nielsen
Christian Pipper
Lars Hansen
Jens J Holst
Jane Thomsen
Jesper Johannesen
Henrik B Mortensen
Jannet Svensson
Source
Diabetologia. 2015 Apr;58(4):828-34
Date
Apr-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Age of Onset
Biomarkers - blood
Blood Glucose - metabolism
Child
Denmark - epidemiology
Diabetes Mellitus, Type 1 - blood - diagnosis - epidemiology
Female
Follow-Up Studies
Glucagon - blood
Hemoglobin A, Glycosylated - metabolism
Humans
Hyperglycemia - blood - diagnosis
Insulin-Secreting Cells - metabolism
Male
Multivariate Analysis
Prospective Studies
Time Factors
Abstract
The influence of glucagon on glycaemic control in type 1 diabetes is debated. We investigated the relationship between postprandial glucagon levels and HbA1c during a period up to 60 months after diagnosis of childhood type 1 diabetes.
The Danish remission phase cohort comprised 129 children (66 boys) with type 1 diabetes whose mean (SD) age at onset was 10.0 (3.9) years. Liquid mixed-meal tests were performed prospectively at 1, 3, 6 and 12 months and a subset of 40 patients completed follow-up at 60 months. Postprandial (90 min) plasma levels of glucagon, glucose (PG), C-peptide, total glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and HbA1c were analysed. Multivariate regression (repeated measurements with all five visits included) was applied and results expressed as relative change (95% CI).
Postprandial glucagon levels increased 160% from 1 to 60 months after diagnosis (p
PubMed ID
25541633 View in PubMed
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Is poor glycaemic control in diabetic patients a risk factor of myopia?

https://arctichealth.org/en/permalink/ahliterature93851
Source
Acta Ophthalmol. 2008 Aug;86(5):510-4
Publication Type
Article
Date
Aug-2008
Author
Jacobsen Nina
Jensen Hanne
Lund-Andersen Henrik
Goldschmidt Ernst
Author Affiliation
Kennedy Institute, National Eye Clinic, Hellerup, Denmark.
Source
Acta Ophthalmol. 2008 Aug;86(5):510-4
Date
Aug-2008
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age of Onset
Blood Glucose - metabolism
Denmark - epidemiology
Diabetes Mellitus, Type 1 - blood - drug therapy
Diabetic Retinopathy - etiology
Female
Follow-Up Studies
Glycemic Index
Hemoglobin A, Glycosylated - metabolism
Humans
Hyperglycemia - etiology
Hypoglycemic agents - therapeutic use
Insulin - therapeutic use
Male
Myopia - epidemiology - etiology
Prevalence
Refractive Errors - etiology
Risk factors
Young Adult
Abstract
PURPOSE: As a consequence of an increasing prevalence of short-sightedness (myopia) in countries that have adopted western dietary patterns, it has been hypothesized that hyperglycaemia and hyperinsulinaemia induce myopia. The purpose of this study was to evaluate the relation between glycosylated haemoglobin (HbA(1c)), insulin dosage and myopia in diabetic patients. METHODS: All type 1 diabetic patients aged 16-26 years [mean age 22.0, standard deviation (SD) 2.9] attending the eye clinic at Steno Diabetes Center, Copenhagen, in 1995-1997 were included in the study (n = 393). The following data were collected from the medical records from baseline to 2005: age at diabetes onset, age at baseline, sex, weight, HbA(1c), insulin dosage, refractive error, visual acuity and ocular diabetes complications. Results: The prevalence of myopia [spherical equivalent (SE)
PubMed ID
18081906 View in PubMed
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Metabolite profiling of LADA challenges the view of a metabolically distinct subtype.

https://arctichealth.org/en/permalink/ahliterature283583
Source
Diabetes. 2017 Apr;66(4):806-814
Publication Type
Article
Date
Apr-2017
Author
Mahmoud Al-Majdoub
Arslan Ali
Petter Storm
Anders H Rosengren
Leif Groop
Peter Spégel
Source
Diabetes. 2017 Apr;66(4):806-814
Date
Apr-2017
Language
English
Publication Type
Article
Keywords
Adult
Age of Onset
Autoantibodies - immunology
Blood Glucose - metabolism
C-Peptide - metabolism
Case-Control Studies
Diabetes Mellitus, Type 1 - metabolism
Diabetes Mellitus, Type 2 - metabolism
Disease Progression
Female
Gas Chromatography-Mass Spectrometry
Glutamate Decarboxylase - immunology
Hemoglobin A, Glycosylated - metabolism
Humans
Hypoglycemic agents - therapeutic use
Insulin - therapeutic use
Latent Autoimmune Diabetes in Adults - drug therapy - immunology - metabolism
Male
Metabolome
Middle Aged
Principal Component Analysis
Sweden
Young Adult
Abstract
Latent autoimmune diabetes in adults (LADA) usually refers to GAD65 autoantibodies (GADAb)-positive diabetes with onset after 35 years of age and no insulin treatment within the first 6 months after diagnosis. However, it is not always easy to distinguish LADA from type 1 or type 2 diabetes. In this study, we examined whether metabolite profiling could help to distinguish LADA (n = 50) from type 1 diabetes (n = 50) and type 2 diabetes (n = 50). Of 123 identified metabolites, 99 differed between the diabetes types. However, no unique metabolite profile could be identified for any of the types. Instead, the metabolome varied along a C-peptide-driven continuum from type 1 diabetes via LADA to type 2 diabetes. LADA was more similar to type 2 diabetes than to type 1 diabetes. In a principal component analysis, LADA patients overlapping with type 1 diabetes progressed faster to insulin therapy than those overlapping with type 2 diabetes. In conclusion, we could not find any unique metabolite profile distinguishing LADA from type 1 and type 2 diabetes. Rather, LADA was metabolically an intermediate of type 1 and type 2 diabetes, with those patients closer to the former showing a faster progression to insulin therapy than those closer to the latter.
PubMed ID
27913577 View in PubMed
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Prevalence of diabetic retinopathy in relation to age at onset of the diabetes, treatment, duration and glycemic control.

https://arctichealth.org/en/permalink/ahliterature48230
Source
Acta Ophthalmol Scand. 1996 Dec;74(6):523-7
Publication Type
Article
Date
Dec-1996
Author
M. Henricsson
A. Nilsson
L. Groop
A. Heijl
L. Janzon
Author Affiliation
Department of Ophthalmology, Helsingborg Hospital, Sweden.
Source
Acta Ophthalmol Scand. 1996 Dec;74(6):523-7
Date
Dec-1996
Language
English
Publication Type
Article
Keywords
Adult
Age of Onset
Aged
Chromatography, High Pressure Liquid
Cross-Sectional Studies
Diabetes Mellitus - blood - drug therapy - epidemiology
Diabetic Retinopathy - blood - epidemiology - therapy
Female
Fundus Oculi
Hemoglobin A, Glycosylated - metabolism
Humans
Hyperglycemia - drug therapy - metabolism
Hypoglycemic agents - therapeutic use
Insulin - therapeutic use
Male
Middle Aged
Prevalence
Research Support, Non-U.S. Gov't
Retrospective Studies
Sweden - epidemiology
Abstract
To study the frequency of diabetic retinopathy in relation to age at diagnosis, treatment, duration of diabetes and glycemic control as measured by means of HbA1c levels, we performed a cross-sectional, registered-based study in the Helsingborg area of southern Sweden, comprising 2232 diabetic patients. Of the known diabetic population or = 30 years the prevalence of retinopathy was 57% in insulin-treated, and 26% in non-insulin treated patients. Levels of glycated hemoglobin and duration of diabetes were associated with retinopathy in the group with younger onset. In the older-onset group, there was a relationship between retinopathy and duration of diabetes and insulin treatment; glycated hemoglobin had a relationship which was of borderline significance with any retinopathy, but clearly significant with the pooled group: severe non-proliferative, proliferative retinopathy and/or macular edema. Hyperglycemia and duration of diabetes were thus associated with retinopathy in both younger- and older-onset diabetes, but hyperglycemia less so in the older-onset group.
PubMed ID
9017034 View in PubMed
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13 records – page 1 of 2.