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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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Acarbose treatment and the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance: the STOP-NIDDM trial.

https://arctichealth.org/en/permalink/ahliterature47380
Source
JAMA. 2003 Jul 23;290(4):486-94
Publication Type
Article
Date
Jul-23-2003
Author
Jean-Louis Chiasson
Robert G Josse
Ramon Gomis
Markolf Hanefeld
Avraham Karasik
Markku Laakso
Author Affiliation
Research Centre, Centre Hospitalier de l'Université de Montréal-Hôtel-Dieu and Department of Medicine, Université de Montréal, Montreal, Quebec, Canada. jean.louis.chiasson@umontreal.ca
Source
JAMA. 2003 Jul 23;290(4):486-94
Date
Jul-23-2003
Language
English
Publication Type
Article
Keywords
Acarbose - therapeutic use
Blood Glucose - metabolism
Cardiovascular Diseases - epidemiology - prevention & control
Diabetes Mellitus, Type 2 - blood - drug therapy
Diabetic Angiopathies - epidemiology - prevention & control
Double-Blind Method
Female
Humans
Hypertension - epidemiology - prevention & control
Hypoglycemic agents - therapeutic use
Male
Middle Aged
Postprandial Period
Research Support, Non-U.S. Gov't
Risk
Risk factors
alpha-Glucosidases - antagonists & inhibitors
Abstract
CONTEXT: The worldwide explosive increase in type 2 diabetes mellitus and its cardiovascular morbidity are becoming major health concerns. OBJECTIVE: To evaluate the effect of decreasing postprandial hyperglycemia with acarbose, an alpha-glucosidase inhibitor, on the risk of cardiovascular disease and hypertension in patients with impaired glucose tolerance (IGT). DESIGN, SETTING, AND PARTICIPANTS: International, multicenter double-blind, placebo-controlled, randomized trial, undertaken in hospitals in Canada, Germany, Austria, Norway, Denmark, Sweden, Finland, Israel, and Spain from July 1998 through August 2001. A total of 1429 patients with IGT were randomized with 61 patients (4%) excluded because they did not have IGT or had no postrandomization data, leaving 1368 patients for a modified intent-to-treat analysis. Both men (49%) and women (51%) participated with a mean (SD) age of 54.5 (7.9) years and body mass index of 30.9 (4.2). These patients were followed up for a mean (SD) of 3.3 (1.2) years. INTERVENTION: Patients with IGT were randomized to receive either placebo (n = 715) or 100 mg of acarbose 3 times a day (n = 714). MAIN OUTCOME MEASURES: The development of major cardiovascular events (coronary heart disease, cardiovascular death, congestive heart failure, cerebrovascular event, and peripheral vascular disease) and hypertension (> or =140/90 mm Hg). RESULTS: Three hundred forty-one patients (24%) discontinued their participation prematurely, 211 in the acarbose-treated group and 130 in the placebo group; these patients were also followed up for outcome parameters. Decreasing postprandial hyperglycemia with acarbose was associated with a 49% relative risk reduction in the development of cardiovascular events (hazard ratio [HR], 0.51; 95% confidence interval [CI]; 0.28-0.95; P =.03) and a 2.5% absolute risk reduction. Among cardiovascular events, the major reduction was in the risk of myocardial infarction (HR, 0.09; 95% CI, 0.01-0.72; P =.02). Acarbose was also associated with a 34% relative risk reduction in the incidence of new cases of hypertension (HR, 0.66; 95% CI, 0.49-0.89; P =.006) and a 5.3% absolute risk reduction. Even after adjusting for major risk factors, the reduction in the risk of cardiovascular events (HR, 0.47; 95% CI, 0.24-0.90; P =.02) and hypertension (HR, 0.62; 95% CI, 0.45-0.86; P =.004) associated with acarbose treatment was still statistically significant. CONCLUSION: This study suggests that treating IGT patients with acarbose is associated with a significant reduction in the risk of cardiovascular disease and hypertension.
Notes
Comment In: ACP J Club. 2004 Jan-Feb;140(1):214711273
Comment In: Curr Diab Rep. 2004 Feb;4(1):1114764272
Comment In: JAMA. 2003 Dec 17;290(23):3066-7; author reply 3067-914679261
Comment In: JAMA. 2003 Dec 17;290(23):3066; author reply 3067-914679262
Comment In: JAMA. 2003 Dec 17;290(23):3066; author reply 3067-914679260
Comment In: JAMA. 2003 Dec 17;290(23):3067; author reply 3067-914679263
PubMed ID
12876091 View in PubMed
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Adaptation of the Diabetes Health Profile (DHP-1) for use with patients with Type 2 diabetes mellitus: psychometric evaluation and cross-cultural comparison.

https://arctichealth.org/en/permalink/ahliterature47802
Source
Diabet Med. 2000 Aug;17(8):572-80
Publication Type
Article
Date
Aug-2000
Author
K A Meadows
C. Abrams
A. Sandbaek
Author Affiliation
Health and Survey Research Unit, Applied Statistics Centre, University of Hull, UK. k.a.meadows@maths.hull.ac.uk
Source
Diabet Med. 2000 Aug;17(8):572-80
Date
Aug-2000
Language
English
Publication Type
Article
Keywords
Affect
Comparative Study
Cross-Cultural Comparison
Denmark
Diabetes Mellitus, Type 2 - physiopathology - psychology - therapy
Diabetic diet
Female
Great Britain
Health status
Humans
Hypoglycemic agents - therapeutic use
Insulin - therapeutic use
Language
Male
Middle Aged
Psychometrics
Quality of Life
Questionnaires
Reproducibility of Results
Research Support, Non-U.S. Gov't
Social Behavior
Abstract
AIMS: To adapt the Diabetes Health Profile (DHP-1) for use with English speaking patients with Type 2 diabetes mellitus and to evaluate the psychometric properties of the adapted measure in a UK and Danish sample of insulin, tablet and diet-treated patients with Type 2 diabetes. METHODS: Following linguistic adaptation using the forward-backward translation procedure, the 32-item DHP-1 was sent to 650 and 800 consecutively selected UK and Danish patients with Type 2 diabetes. Construct validity was assessed using principal axis factoring. Factor stability was assessed across language groups using the coefficient of congruence. Reliability was evaluated using Cronbach's alpha and multi-trait analysis, including item convergent/discriminant validity. Subscale discriminant validity was assessed through known groups with one-way ANOVA and post hoc Scheffe tests for multiple comparisons. RESULTS: Eighteen items (56.25%) were retained following initial item analysis. A three-factor solution accounting for 45.6% and 40.3% of the total explained variance was identified in the UK and Danish samples, respectively. Factors were interpreted as psychological distress (PD), barriers to activity (BA) and disinhibited eating (DE). Factor congruence between language groups ranged from 0.98 to 0.99 and Cronbach's alpha ranged between 0.70 and 0.88. Item scaling success for both language versions was 88.9%. BA scores discriminated between treatment groups in both language groups (F = 24.24, P
PubMed ID
11073178 View in PubMed
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Adiposity in 277 young adult male offspring of women with diabetes compared with controls: a Danish population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature125402
Source
Acta Obstet Gynecol Scand. 2012 Jul;91(7):838-43
Publication Type
Article
Date
Jul-2012
Author
Gunnar Lauge Nielsen
Claus Dethlefsen
Søren Lundbye-Christensen
Jan Fog Pedersen
Lars Mølsted-Pedersen
Matt W Gillman
Author Affiliation
Department of Internal Medicine, Himmerland Hospital, Farsø, Denmark. guln@rn.dk
Source
Acta Obstet Gynecol Scand. 2012 Jul;91(7):838-43
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Adiposity - genetics
Case-Control Studies
Confidence Intervals
Denmark - epidemiology
Diabetes, Gestational - drug therapy - epidemiology
Female
Humans
Hypoglycemic agents - therapeutic use
Insulin - therapeutic use
Male
Military Personnel
Personnel Selection
Population Surveillance
Pregnancy
Pregnancy in Diabetics - drug therapy - epidemiology
Risk factors
Young Adult
Abstract
To examine the associations of maternal diabetes, overall and stratified according to treatment of diabetes, with weight-related outcomes at the time of military conscription, at age 18-20 years.
Cohort study of 277 Danish male offspring of mothers with recognized pre-gestational or gestational diabetes. As population-based controls we selected 870 men matched from the Civil Registration Office.
Data on weight-related outcomes were retrieved from the Danish military conscription registry.
Military rejection due to adiposity and body mass index (BMI) at conscription.
Army rejection rate due to adiposity was 5.8% (n= 16) among 277 diabetes mellitus-exposed men compared with 3.1% (n= 27) in 870 controls (risk difference 2.7 (95% confidence interval (CI) -0.3-5.7)) and mean BMI at conscription was 1.4 kg/m(2) (95%CI 0.8-2.0) higher among those diabetes mellitus-exposed men. In analyses adjusted for birthweight and gestational age, compared with controls, the BMI was 0.6 kg/m(2) (95%CI -0.3-1.5) higher in sons of mothers with pre-gestational and 2.7 kg/m(2) (95% (CI): 0.9-4.5) higher with gestational diabetes. The greatest BMI difference was in offspring of mothers with gestational diabetes in whom insulin was initiated during pregnancy. We found no difference in conscript height.
Compared with controls, male offspring of women with diabetes had a higher rejection rate due to adiposity and higher adult BMI. Subgroup analyses showed that the association was most pronounced in sons of mothers with gestational diabetes, whereas pre-gestational diabetes was only weakly associated with higher offspring BMI.
PubMed ID
22486385 View in PubMed
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Admission Hyperglycemia and Clinical Outcome in Cerebral Venous Thrombosis.

https://arctichealth.org/en/permalink/ahliterature273503
Source
Stroke. 2016 Feb;47(2):390-6
Publication Type
Article
Date
Feb-2016
Author
Susanna M Zuurbier
Sini Hiltunen
Turgut Tatlisumak
Guusje M Peters
Suzanne M Silvis
Elena Haapaniemi
Nyika D Kruyt
Jukka Putaala
Jonathan M Coutinho
Source
Stroke. 2016 Feb;47(2):390-6
Date
Feb-2016
Language
English
Publication Type
Article
Keywords
Adult
Anticoagulants - therapeutic use
Cerebral Hemorrhage - epidemiology - therapy
Cohort Studies
Coma - epidemiology
Comorbidity
Decompressive Craniectomy
Female
Finland - epidemiology
Humans
Hyperglycemia - drug therapy - epidemiology
Hypoglycemic agents - therapeutic use
Insulin - therapeutic use
Intensive Care Units - utilization
Intracranial Thrombosis - epidemiology - mortality - therapy
Logistic Models
Male
Middle Aged
Netherlands - epidemiology
Odds Ratio
Prognosis
Retrospective Studies
Severity of Illness Index
Sinus Thrombosis, Intracranial - epidemiology - mortality - therapy
Venous Thrombosis - epidemiology - mortality - therapy
Abstract
Admission hyperglycemia is associated with poor clinical outcome in ischemic and hemorrhagic stroke. Admission hyperglycemia has not been investigated in patients with cerebral venous thrombosis.
Consecutive adult patients with cerebral venous thrombosis were included at the Academic Medical Center, The Netherlands (2000-2014) and the Helsinki University Central Hospital, Finland (1998-2014). We excluded patients with known diabetes mellitus and patients without known admission blood glucose. We defined admission hyperglycemia as blood glucose =7.8 mmol/L (141 mg/dL) and severe hyperglycemia as blood glucose =11.1 mmol/L (200 mg/dL). We used logistic regression analysis to determine if admission hyperglycemia was associated with modified Rankin Scale (mRS) score of 3 to 6 or mortality at last follow-up. We adjusted for: age, sex, coma, malignancy, infection, intracerebral hemorrhage, deep cerebral venous thrombosis, and location of recruitment.
Of 380 patients with cerebral venous thrombosis, 308 were eligible. Of these, 66 (21.4%) had admission hyperglycemia with 8 (2.6%) having severe admission hyperglycemia. Coma (31.3% versus 5.0%, P
PubMed ID
26670083 View in PubMed
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[ADOPT study: which first-line glucose-lowering oral medication in type 2 diabetes?].

https://arctichealth.org/en/permalink/ahliterature164781
Source
Rev Med Liege. 2007 Jan;62(1):48-52
Publication Type
Article
Date
Jan-2007
Author
A J Scheen
Author Affiliation
Université de Liège, Belgique.
Source
Rev Med Liege. 2007 Jan;62(1):48-52
Date
Jan-2007
Language
French
Publication Type
Article
Keywords
Administration, Oral
Belgium
Canada
Cost-Benefit Analysis
Diabetes Mellitus, Type 2 - drug therapy - economics
Double-Blind Method
European Union
Glyburide - therapeutic use
Humans
Hypoglycemic agents - therapeutic use
Metformin - therapeutic use
Middle Aged
Quality of Life
Thiazolidinediones - therapeutic use
Treatment Outcome
United States
Abstract
ADOPT ("A Diabetes Outcome Progression Trial") is a double-blind, controlled clinical trial that aims at assessing the efficacy of rosiglitazone, as compared to metformin or glibenclamide, in maintaining long-term glycaemic control in patients with recently diagnosed type 2 diabetes. It randomized 4,360 patients who were followed for a median of 4.0 years. The cumulative incidence of monotherapy failure (defined as a confirmed level of fasting plasma glucose level of more than 180 mg/dl) averaged at 5 years 15% with rosiglitazone, 21% with metformin, and 34% with glibenclamide. This represents a risk reduction for rosiglitazone of 32% as compared to metformin and 63% as compared to glibenclamide (P
PubMed ID
17343130 View in PubMed
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All-Cause and Cause-Specific Mortality among Users of Basal Insulins NPH, Detemir, and Glargine.

https://arctichealth.org/en/permalink/ahliterature275159
Source
PLoS One. 2016;11(3):e0151910
Publication Type
Article
Date
2016
Author
Arto Y Strandberg
Fabian J Hoti
Timo E Strandberg
Solomon Christopher
Jari Haukka
Pasi Korhonen
Source
PLoS One. 2016;11(3):e0151910
Date
2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cardiovascular Diseases - epidemiology - mortality
Cause of Death
Cohort Studies
Databases, Factual
Diabetes Mellitus, Type 2 - drug therapy
Female
Finland
Gastrointestinal Diseases - epidemiology - mortality
Humans
Hypoglycemic agents - therapeutic use
Insulin Glargine - therapeutic use
Insulin, Isophane - therapeutic use
Insulin, Long-Acting - therapeutic use
Male
Middle Aged
Neoplasms - epidemiology - mortality
Risk
Abstract
Insulin therapy in type 2 diabetes may increase mortality and cancer incidence, but the impact of different types of basal insulins on these endpoints is unclear. Compared to the traditional NPH insulin, the newer, longer-acting insulin analogues detemir and glargine have shown benefits in randomized controlled trials. Whether these advantages translate into lower mortality among users in real life is unknown.
To estimate the differences in all-cause and cause-specific mortality rates between new users of basal insulins in a population-based study in Finland.
23 751 individuals aged =40 with type 2 diabetes, who initiated basal insulin therapy in 2006-2009 were identified from national registers, with comprehensive data for mortality, causes of death, and background variables. Propensity score matching was performed on characteristics. Follow-up time was up to 4 years (median 1.7 years).
2078 deaths incurred. With NPH as reference, the adjusted HRs for all-cause mortality were 0.39 (95% CI, 0.30-0.50) for detemir, and 0.55 (95% CI, 0.44-0.69) for glargine. As compared to glargine, the HR was 0.71 (95% CI, 0.54-0.93) among detemir users. Compared to NPH, the mortality risk for both cardiovascular causes as well as cancer were also significantly lower for glargine, and especially for detemir in adjusted analysis. Furthermore, the results were robust in various sensitivity analyses.
In real clinical practice, mortality was substantially higher among users of NPH insulin as compared to insulins detemir or glargine. Considering the large number of patients who require insulin therapy, this difference in risk may have major clinical and public health implications. Due to limitations of the observational study design, further investigation using an interventional study design is warranted.
Notes
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PubMed ID
27031113 View in PubMed
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All-cause mortality and pharmacological treatment intensity following a high risk screening program for diabetes. A 6.6 year follow-up of the ADDITION study, Denmark.

https://arctichealth.org/en/permalink/ahliterature124294
Source
Prim Care Diabetes. 2012 Oct;6(3):193-200
Publication Type
Article
Date
Oct-2012
Author
Torsten Lauritzen
Annelli Sandbaek
Anders Helles Carlsen
Knut Borch-Johnsen
Author Affiliation
School of Public Health, Department of General Practice, University of Aarhus, Denmark. tl@alm.au.dk
Source
Prim Care Diabetes. 2012 Oct;6(3):193-200
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Adult
Antihypertensive Agents - therapeutic use
Biological Markers - blood
Blood Glucose - drug effects - metabolism
Chi-Square Distribution
Comorbidity
Denmark
Diabetes Mellitus - blood - diagnosis - drug therapy - mortality
Dyslipidemias - diagnosis - drug therapy - mortality
Female
Hemoglobin A, Glycosylated - metabolism
Humans
Hypertension - diagnosis - drug therapy - mortality
Hypoglycemic agents - therapeutic use
Hypolipidemic Agents - therapeutic use
Kaplan-Meier Estimate
Male
Mass Screening - methods
Middle Aged
Predictive value of tests
Proportional Hazards Models
Questionnaires
Risk assessment
Risk factors
Time Factors
Treatment Outcome
Abstract
To study all-cause mortality and pharmacological treatment intensity in relation to baseline glucose metabolism and HbA1c following high risk screening for diabetes in primary care.
Persons aged 40-69 years (N=163,185) received mailed diabetes risk questionnaires. 20,916 persons without diabetes but with high risk of diabetes were stratified by glucose metabolism (normal glucose tolerance (NGT), dysglycemia (IFG or IGT) or diabetes) and by HbA1c at screening (
Notes
Comment In: Prim Care Diabetes. 2012 Dec;6(4):341-222917774
PubMed ID
22595031 View in PubMed
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An algorithm to differentiate diabetic respondents in the Canadian Community Health Survey.

https://arctichealth.org/en/permalink/ahliterature157393
Source
Health Rep. 2008 Mar;19(1):71-9
Publication Type
Article
Date
Mar-2008
Author
Edward Ng
Kaberi Dasgupta
Jeffrey A Johnson
Author Affiliation
Health Information and Research Division at Statistics Canada in Ottawa, Ontario K1A 0T6. Edward.Ng@statcan.ca
Source
Health Rep. 2008 Mar;19(1):71-9
Date
Mar-2008
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Algorithms
Canada
Decision Trees
Diabetes Mellitus - classification - diagnosis - drug therapy - physiopathology
Female
Health Surveys
Humans
Hypoglycemic agents - therapeutic use
Insulin - therapeutic use
Male
Pregnancy
Abstract
This article describes an algorithm to classify respondents to cycle 1.1 (2000/2001) of the Canadian Community Health Survey (CCHS) according to whether they have type 1, type 2 or gestational diabetes.
The data are from the chronic disease module and the drug module of cycle 1.1 of the CCHS.
A total of 6,361 respondents to cycle 1.1 of the CCHS reported that a health care professional had diagnosed them as having diabetes. The Ng-Dasgupta-Johnson algorithm classifies this group according to whether they have type 1, type 2 or gestational diabetes, based on their answers to CCHS questions about diabetes during pregnancy, use of oral medications to control diabetes, use of insulin, timing of initiation of insulin treatment, and age at diagnosis.
Application of an earlier algorithm to CCHS cycle 1.1 results in a 10%-90% split for type 1 and type 2 diabetes. By contrast, the Ng-Dasgupta-Johnson algorithm yields a 5%-95% split. This is not unreasonable, given the rapid rise in obesity, a major risk factor for type 2 diabetes, in Canada.
PubMed ID
18457213 View in PubMed
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285 records – page 1 of 29.