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Adherence to national diabetes guidelines through monitoring quality indicators--A comparison of three types of care for the elderly with special emphasis on HbA1c.

https://arctichealth.org/en/permalink/ahliterature271560
Source
Prim Care Diabetes. 2015 Aug;9(4):253-60
Publication Type
Article
Date
Aug-2015
Author
Ann-Sofie Nilsson Neumark
Lars Brudin
Thomas Neumark
Source
Prim Care Diabetes. 2015 Aug;9(4):253-60
Date
Aug-2015
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Biomarkers - blood
Blood Glucose - drug effects - metabolism
Cross-Sectional Studies
Diabetes Mellitus, Type 1 - blood - diagnosis - drug therapy - epidemiology
Diabetes Mellitus, Type 2 - blood - diagnosis - drug therapy - epidemiology
Female
Guideline Adherence - standards
Health Services for the Aged - standards
Hemoglobin A, Glycosylated - metabolism
Home Care Services
Homes for the Aged
Humans
Hypoglycemic Agents - adverse effects - therapeutic use
Independent living
Male
Nursing Homes
Practice Guidelines as Topic - standards
Practice Patterns, Physicians' - standards
Prevalence
Process Assessment (Health Care) - standards
Quality Indicators, Health Care - standards
Sweden - epidemiology
Treatment Outcome
Abstract
To compare adherence to Swedish guidelines for diabetes care between elderly people living at home with or without home health care, and residents of nursing homes.
Medical records of 277 elderly people aged 80 and older, with known diabetes in a Swedish municipality, were monitored using quality indicators to evaluate processes and outcomes.
Monitoring, in accordance to diabetes guidelines, of HbA1c, lipids, blood pressure and foot examinations was lower among residents of nursing homes (p
PubMed ID
25865853 View in PubMed
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Association between glycemic control and adverse outcomes in people with diabetes mellitus and chronic kidney disease: a population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature129274
Source
Arch Intern Med. 2011 Nov 28;171(21):1920-7
Publication Type
Article
Date
Nov-28-2011
Author
Sabin Shurraw
Brenda Hemmelgarn
Meng Lin
Sumit R Majumdar
Scott Klarenbach
Braden Manns
Aminu Bello
Matthew James
Tanvir Chowdhury Turin
Marcello Tonelli
Author Affiliation
Divisions of Nephrology, University of Alberta, Edmonton, Canada.
Source
Arch Intern Med. 2011 Nov 28;171(21):1920-7
Date
Nov-28-2011
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Alberta - epidemiology
Biological Markers - blood
Cardiovascular Diseases - etiology - metabolism
Cohort Studies
Diabetes Mellitus - metabolism - mortality - therapy
Diabetic Nephropathies - metabolism
Female
Glomerular Filtration Rate
Hemoglobin A, Glycosylated - metabolism
Hospitalization - statistics & numerical data
Humans
Kidney Failure, Chronic - complications - metabolism
Male
Middle Aged
Abstract
Better glycemic control as reflected by lower hemoglobin A(1c) (HbA(1c)) level may prevent or slow progression of nephropathy in people with diabetes mellitus (DM). Whether a lower HbA(1c) level improves outcomes in people with DM and chronic kidney disease (CKD) is unknown.
From all people with serum creatinine measured as part of routine care in a single Canadian province from 2005 through 2006, we identified those with CKD based on laboratory data (estimated glomerular filtration rate [eGFR],
Notes
Comment In: Arch Intern Med. 2011 Nov 28;171(21):1927-822123801
Comment In: Arch Intern Med. 2012 Apr 9;172(7):596; discussion 596-722493472
PubMed ID
22123800 View in PubMed
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The associations of endogenous testosterone and sex hormone-binding globulin with glycosylated hemoglobin levels, in community dwelling men. The Tromsø Study.

https://arctichealth.org/en/permalink/ahliterature47274
Source
Diabetes Metab. 2004 Feb;30(1):29-34
Publication Type
Article
Date
Feb-2004
Author
J. Svartberg
T. Jenssen
J. Sundsfjord
R. Jorde
Author Affiliation
Department of Medicine, University Hospital of North Norway, N-9038 Tromsø, Norway.
Source
Diabetes Metab. 2004 Feb;30(1):29-34
Date
Feb-2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Body constitution
Body mass index
Comparative Study
Cross-Sectional Studies
Diabetes Mellitus - blood
Health Surveys
Hemoglobin A, Glycosylated - metabolism
Humans
Male
Middle Aged
Norway
Questionnaires
Reference Values
Research Support, Non-U.S. Gov't
Sex Hormone-Binding Globulin - metabolism
Smoking
Testosterone - blood
Abstract
OBJECTIVES: Low levels of endogenous testosterone have been associated with increased risk of cardiovascular disease and atherosclerosis in men. Long-term hyperglycemia, as measured by glycosylated hemoglobin (HbA1c), is related to cardiovascular mortality, and HbA1c across its normal range is also positively related to coronary heart and cardiovascular disease mortality in men. We therefore undertook an analysis of the cross-sectional associations of total testosterone and SHBG levels with HbA1c levels, in a general population of 1419 men aged 25-84.METHODS: Total testosterone, sex hormone-binding globulin (SHBG) and HbA1c were measured by immuno-assay. Partial correlation and multiple regression analyses were used to estimate the associations between total testosterone and SHBG with HbA1c. Analyses of variance and covariance were used to compare men with or without diabetes.RESULTS: In age-adjusted partial correlation HbA1c was inversely associated with total testosterone (p
PubMed ID
15029095 View in PubMed
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Can diabetes medication be reduced in elderly patients? An observational study of diabetes drug withdrawal in nursing home patients with tight glycaemic control.

https://arctichealth.org/en/permalink/ahliterature91835
Source
Diabetes Res Clin Pract. 2008 Nov;82(2):197-202
Publication Type
Article
Date
Nov-2008
Author
Sjöblom Peter
AndersTengblad
Löfgren Ulla-Britt
Lannering Christina
Anderberg Niklas
Rosenqvist Ulf
Mölstad Sigvard
Ostgren Carl J
Author Affiliation
Söderköping Primary Health Care Centre, Ostra Rydsvägen, S-614 82 Söderköping, Sweden. Peter.Sjoblom@lio.se
Source
Diabetes Res Clin Pract. 2008 Nov;82(2):197-202
Date
Nov-2008
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Blood Glucose - metabolism
Diabetes Mellitus - blood - drug therapy
Drug Administration Schedule
Female
Hemoglobin A, Glycosylated - metabolism
Humans
Hypoglycemic Agents - administration & dosage
Male
Middle Aged
Nursing Homes
Abstract
AIM: To explore the feasibility of withdrawal of diabetes medication in elderly patients with HbA1c
PubMed ID
18823673 View in PubMed
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Cardiovascular disease and risk factors in three Alaskan Eskimo populations: the Alaska-Siberia project.

https://arctichealth.org/en/permalink/ahliterature3409
Source
Int J Circumpolar Health. 2005 Sep;64(4):365-86
Publication Type
Article
Date
Sep-2005
Author
Sven O E Ebbesson
Amanda I Adler
Patricia M Risica
Lars O E Ebbesson
Jeun-Liang Yeh
Oskar T Go
William Doolittle
Gary Ehlert
Michael Swenson
David C Robbins
Author Affiliation
Department of Neurological Surgery, University of Virginia, Charlottesville 22908-0212, USA. se6b@virginia.edu
Source
Int J Circumpolar Health. 2005 Sep;64(4):365-86
Date
Sep-2005
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Aged, 80 and over
Alaska - epidemiology
Albuminuria - metabolism
Body mass index
Cardiovascular Diseases - ethnology - metabolism
Comorbidity
Comparative Study
Cross-Sectional Studies
Female
Hemoglobin A, Glycosylated - metabolism
Humans
Hypertension - ethnology
Insulin - blood
Inuits - statistics & numerical data
Life Style
Lipids - blood
Logistic Models
Male
Middle Aged
Obesity - ethnology
Prevalence
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.
Risk factors
Sex Distribution
Smoking - ethnology
Waist-Hip Ratio - statistics & numerical data
Abstract
OBJECTIVES: To determine the prevalence of CVD and to identify and characterize associated risk factors in three distinct Eskimo populations. STUDY DESIGN: Cross-sectional. METHODS: A slightly modified Strong Heart Study protocol was followed to examine 454 participants, aged 25-91, from four villages. RESULTS: Overall, 6% of the participants under 55 years of age and 26% of those > or = 55 years of age showed evidence of CHD by ECG, or in patient records. The prevalence of "definite coronary heart disease" (CHD) in women with glucose intolerance (GI) was 21.0%, compared to 2.4% in those with normal glucose tolerance (NGT). Men had comparable values of 26.7% and 6.3%. In addition, comparable values for "possible CHD" were 29.7% vs 6.0% for women and 21.4% vs 8.0% for men. GI was associated with relatively higher prevalences of CHD in women than in men (prevalence ratio = 8.5 vs 4.3). CHD was significantly related to age, glucose intolerance and insulin. Hypertension and obesity were significantly associated with CHD only in some ethnic groups. The prevalence of current smokers was 56%. CONCLUSIONS: Recent changes in lifestyle and diet of Alaskan Eskimos, leading to obesity, hypertension, insulin resistance and DM, contribute to an increased risk for cardiovascular disease.
PubMed ID
16277121 View in PubMed
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The cross-sectional associations between sense of coherence and diabetic microvascular complications, glycaemic control, and patients' conceptions of type 1 diabetes.

https://arctichealth.org/en/permalink/ahliterature139026
Source
Health Qual Life Outcomes. 2010;8:142
Publication Type
Article
Date
2010
Author
Aila J Ahola
Markku Saraheimo
Carol Forsblom
Kustaa Hietala
Per-Henrik Groop
Author Affiliation
Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Finland. per-henrik.groop@helsinki.fi
Source
Health Qual Life Outcomes. 2010;8:142
Date
2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Blood pressure
Cross-Sectional Studies
Diabetes Mellitus, Type 1 - blood - psychology - therapy
Diabetic Angiopathies - blood - complications - prevention & control
Diabetic Nephropathies - diagnosis
Female
Finland
Hemoglobin A, Glycosylated - metabolism
Humans
Hyperglycemia - blood - prevention & control
Life Style
Male
Middle Aged
Quality of Life
Questionnaires
Sense of Coherence
Sex Factors
Abstract
Sense of coherence (SOC) has been associated with various self-care behaviours in the general population. As the management of type 1 diabetes heavily relies on self-management, the SOC concept could also prove important in this population. This paper is a report of a study conducted among patients with type 1 diabetes to assess the associations between SOC and glycaemic control, microvascular complications, and patients' conceptions of their disease.
Altogether 1,264 adult patients (45% men, age range 18-82 years) with type 1 diabetes participated in this cross-sectional study. SOC was evaluated using a 13-item SOC questionnaire. Standardized assays were used to determine HbA1c. Nephropathy status was based on albumin excretion rate and retinal laser-treatment was used as an indication of severe retinopathy. Patients' subjective conceptions of diabetes were studied using a questionnaire.
Higher SOC scores, reflecting stronger SOC, were associated with lower HbA1c values. Strong SOC was independently associated with reaching the HbA1c level
Notes
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PubMed ID
21110902 View in PubMed
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Diabetes and it's complications in a Swedish county.

https://arctichealth.org/en/permalink/ahliterature48096
Source
Diabetes Res Clin Pract. 1998 Feb;39(2):157-64
Publication Type
Article
Date
Feb-1998
Author
B. Lundman
L. Engström
Author Affiliation
Department of Advanced Nursing, Umeå University, Sweden. berit.lundman@nurssci.umu.se
Source
Diabetes Res Clin Pract. 1998 Feb;39(2):157-64
Date
Feb-1998
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Albuminuria - complications
Cardiovascular Diseases - complications
Data Interpretation, Statistical
Diabetes Mellitus, Type 1 - complications - epidemiology - therapy
Diabetes Mellitus, Type 2 - complications - epidemiology - therapy
Diabetic diet
Diabetic Ketoacidosis - complications
Diabetic Nephropathies - epidemiology - therapy
Diabetic Neuropathies - epidemiology - therapy
Diabetic Retinopathy - epidemiology - therapy
Female
Fundus Oculi
Health Services - statistics & numerical data - utilization
Hemoglobin A, Glycosylated - metabolism
Humans
Hypertension - complications
Hypoglycemic agents - therapeutic use
Insulin - therapeutic use
Male
Middle Aged
Myocardial Infarction - complications
Ophthalmoscopy
Prevalence
Prospective Studies
Sex Factors
Smoking
Sulfonylurea Compounds - therapeutic use
Sweden - epidemiology
Abstract
A cross-sectional survey with the aim to study the prevalence of diabetes and long-term complications was carried out in a health care district in Sweden with 125,500 inhabitants. Information was extracted from the medical records. 4127 people with diabetes were identified of whom 87% were classified as NIDDM (non-insulin-dependent diabetes mellitus), 12% as IDDM (insulin-dependent diabetes mellitus) and 0.7% as secondary or unclassified diabetes. The prevalence of diagnosed diabetes was 3.3%. A total of 83% received their regular routine care at primary health care centres, 31% were treated with diet only, 36% had oral hypoglycaemic agents, 31% had insulin and 2% had combination therapy. The mean HbA1c was 7.2% (ref. range 4.0-5.3%). Of the adults (> 18 years) 27% had retinopathy, 13% had nephropathy and 27% had loss of pallaesthesia. 50% had hypertension, 21% angina pectoris, 11% had had myocardial infarction, 11% stroke, 21% had signs of peripheral arterial disease, 2% had been amputated and 21% were smokers. The conclusion is that in a population of patients with diabetes with acceptable metabolic control, complications are still a great problem.
PubMed ID
9597386 View in PubMed
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Diabetic vitrectomy in a large type 1 diabetes patient population: long-term incidence and risk factors.

https://arctichealth.org/en/permalink/ahliterature260706
Source
Acta Ophthalmol. 2014 Aug;92(5):439-43
Publication Type
Article
Date
Aug-2014
Author
Christoffer Ostri
Morten la Cour
Henrik Lund-Andersen
Source
Acta Ophthalmol. 2014 Aug;92(5):439-43
Date
Aug-2014
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Blood Glucose - metabolism
Blood pressure
Denmark - epidemiology
Diabetes Mellitus, Type 1 - blood - epidemiology - surgery
Diabetic Nephropathies - epidemiology
Diabetic Retinopathy - blood - epidemiology - surgery
Female
Hemoglobin A, Glycosylated - metabolism
Humans
Incidence
Laser Coagulation
Male
Middle Aged
Prospective Studies
Registries
Retrospective Studies
Risk factors
Vitrectomy - statistics & numerical data
Young Adult
Abstract
Diabetic vitrectomy represents an end-point of diabetic retinopathy progression. This study was designed to estimate long-term incidence of diabetic vitrectomy and associated risk factors.
Retrospective review of prospectively collected data from a large diabetes centre between 1996 and 2010. Surgical history was obtained from The Danish National Patient Register.
The population consisted of 3980 patients with type 1 diabetes. Median follow-up was 10.0 years. In total, 106 patients underwent diabetic vitrectomy in the observation period. Surgery indications were nonclearing vitreous haemorrhage (43%) or tractional retinal detachment (57%). The cumulative incidence rates of diabetic vitrectomy were 1.6% after 5 years and 2.9% after 10 years. When excluding patients with no or mild diabetic retinopathy, the corresponding rates were higher; 3.7% and 6.4%, respectively (p 75 mmol/mol in the observation period (p 0.05 for all variables).
Diabetic vitrectomy is rarely required in a type 1 diabetes population with varying degrees of retinopathy, but the risk increases markedly with poor metabolic control.
PubMed ID
23910735 View in PubMed
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Evaluation of four novel genetic variants affecting hemoglobin A1c levels in a population-based type 2 diabetes cohort (the HUNT2 study).

https://arctichealth.org/en/permalink/ahliterature137324
Source
BMC Med Genet. 2011;12:20
Publication Type
Article
Date
2011
Author
Jens K Hertel
Stefan Johansson
Helge Ræder
Carl G P Platou
Kristian Midthjell
Kristian Hveem
Anders Molven
Pål R Njølstad
Author Affiliation
Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Source
BMC Med Genet. 2011;12:20
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Blood Glucose - metabolism
DNA-Binding Proteins - genetics
Diabetes Mellitus, Type 2 - blood - genetics
Female
Genetic Variation
Genome-Wide Association Study
Genotype
Goosecoid Protein - genetics
Hemoglobin A, Glycosylated - metabolism
Humans
Hyperglycemia
Male
Middle Aged
Norway
Polymorphism, Single Nucleotide
Proteins - genetics
Receptors, Cell Surface - genetics
Abstract
Chronic hyperglycemia confers increased risk for long-term diabetes-associated complications and repeated hemoglobin A1c (HbA1c) measures are a widely used marker for glycemic control in diabetes treatment and follow-up. A recent genome-wide association study revealed four genetic loci, which were associated with HbA1c levels in adults with type 1 diabetes. We aimed to evaluate the effect of these loci on glycemic control in type 2 diabetes.
We genotyped 1,486 subjects with type 2 diabetes from a Norwegian population-based cohort (HUNT2) for single-nucleotide polymorphisms (SNPs) located near the BNC2, SORCS1, GSC and WDR72 loci. Through regression models, we examined their effects on HbA1c and non-fasting glucose levels individually and in a combined genetic score model.
No significant associations with HbA1c or glucose levels were found for the SORCS1, BNC2, GSC or WDR72 variants (all P-values > 0.05). Although the observed effects were non-significant and of much smaller magnitude than previously reported in type 1 diabetes, the SORCS1 risk variant showed a direction consistent with increased HbA1c and glucose levels, with an observed effect of 0.11% (P = 0.13) and 0.13 mmol/l (P = 0.43) increase per risk allele for HbA1c and glucose, respectively. In contrast, the WDR72 risk variant showed a borderline association with reduced HbA1c levels (ß = -0.21, P = 0.06), and direction consistent with decreased glucose levels (ß = -0.29, P = 0.29). The allele count model gave no evidence for a relationship between increasing number of risk alleles and increasing HbA1c levels (ß = 0.04, P = 0.38).
The four recently reported SNPs affecting glycemic control in type 1 diabetes had no apparent effect on HbA1c in type 2 diabetes individually or by using a combined genetic score model. However, for the SORCS1 SNP, our findings do not rule out a possible relationship with HbA1c levels. Hence, further studies in other populations are needed to elucidate whether these novel sequence variants, especially rs1358030 near the SORCS1 locus, affect glycemic control in type 2 diabetes.
Notes
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PubMed ID
21294870 View in PubMed
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Field test of a group education program for type 2 diabetes: measures and predictors of success on individual and group levels.

https://arctichealth.org/en/permalink/ahliterature47695
Source
Patient Educ Couns. 2001 Aug;44(2):129-39
Publication Type
Article
Date
Aug-2001
Author
A. Sarkadi
U. Rosenqvist
Author Affiliation
Department of Public Health and Caring Sciences, Uppsala University, Uppsala Science Park, SE-751 85, Uppsala, Sweden.
Source
Patient Educ Couns. 2001 Aug;44(2):129-39
Date
Aug-2001
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Attitude to Health
Diabetes Mellitus, Type 2 - etiology - metabolism - prevention & control - psychology
Female
Hemoglobin A, Glycosylated - metabolism
Humans
Interpersonal Relations
Loneliness
Male
Middle Aged
Needs Assessment
Obesity - complications - prevention & control
Patient Education - methods - standards
Predictive value of tests
Program Evaluation
Questionnaires
Research Support, Non-U.S. Gov't
Self Care - methods - standards
Self-Help Groups - standards
Social Support
Sweden
Treatment Outcome
Abstract
We performed field testing of a previously described group education program for type 2 diabetes. HbA(1c) levels at start, 6 and 12 months were collected and demographic factors examined to identify predictors of long-term glycemic control on individual and group levels. "Glycemic success" comprised of (1) achieving target values of HbA(1c)
PubMed ID
11479053 View in PubMed
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34 records – page 1 of 4.