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Changes in glucose metabolism in people with different glucose metabolism disorders at baseline: follow-up results of a Finnish national diabetes prevention programme.

https://arctichealth.org/en/permalink/ahliterature277251
Source
Diabet Med. 2015 Dec;32(12):1611-6
Publication Type
Article
Date
Dec-2015
Author
N. Rautio
J. Jokelainen
H. Oksa
T. Saaristo
M. Peltonen
H. Puolijoki
J. Tuomilehto
M. Vanhala
L. Moilanen
M. Uusitupa
S. Keinänen-Kiukaanniemi
Source
Diabet Med. 2015 Dec;32(12):1611-6
Date
Dec-2015
Language
English
Publication Type
Article
Keywords
Anti-Obesity Agents - therapeutic use
Body mass index
Combined Modality Therapy
Diabetes Mellitus, Type 2 - epidemiology - etiology - prevention & control
Diet, Diabetic
Diet, Reducing
Disease Progression
Female
Finland - epidemiology
Follow-Up Studies
Glucose Intolerance - complications - diet therapy - physiopathology - therapy
Humans
Hypoglycemic agents - therapeutic use
Life Style
Male
Middle Aged
Motor Activity
Nutrition Policy
Overweight - complications - diet therapy - drug therapy - therapy
Patient compliance
Prediabetic State - complications - diet therapy - physiopathology - therapy
Primary Health Care
Risk
Weight Loss
Abstract
To examine changes in glucose metabolism (fasting and 2-h glucose) during follow-up in people with impaired fasting glucose in comparison with changes in people with isolated impaired glucose tolerance, people with impaired fasting glucose and impaired glucose tolerance combined and people with screening-detected Type 2 diabetes at baseline, among those who participated in a diabetes prevention programme conducted in Finland.
A total of 10 149 people at high risk of Type 2 diabetes took part in baseline examination. Of 5351 individuals with follow-up = 9 months, 1727 had impaired glucose metabolism at baseline and completed at least one lifestyle intervention visit. Most of them (94.6%) were overweight/ obese.
Fasting glucose decreased during follow-up among overweight/obese people in the combined impaired fasting glucose and impaired glucose tolerance group (P = 0.044), as did 2-h glucose in people in the isolated impaired glucose tolerance group (P = 0.0014) after adjustment for age, sex, medication and weight at baseline, follow-up time and changes in weight, physical activity and diet. When comparing changes in glucose metabolism among people with different degrees of glucose metabolism impairment, fasting glucose concentration was found to have increased in those with isolated impaired glucose tolerance (0.12 mmol/l, 95% Cl 0.05 to 0.19) and it decreased to a greater extent in those with screening-detected Type 2 diabetes (-0.54 mmol/l, 95% Cl -0.69 to -0.39) compared with those with impaired fasting glucose (-0.21 mmol/l, 95% Cl -0.27 to -0.15). Furthermore, 2-h glucose concentration decreased in the isolated impaired glucose tolerance group (-0.82 mmol/l, 95% Cl -1.04 to -0.60), in the combined impaired fasting glucose and impaired glucose tolerance group (-0.82 mmol/l, 95% Cl -1.07 to -0.58) and in the screening-detected Type 2 diabetes group (-1.52, 95% Cl -1.96 to -1.08) compared with those in the impaired fasting glucose group (0.26 mmol/l, 95% Cl 0.10 to 0.43). Results were statistically significant even after adjustment for covariates (P
PubMed ID
25864699 View in PubMed
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Differentiated long-term effects of intentional weight loss on diabetes and hypertension.

https://arctichealth.org/en/permalink/ahliterature47843
Source
Hypertension. 2000 Jul;36(1):20-5
Publication Type
Article
Date
Jul-2000
Author
C D Sjöström
M. Peltonen
H. Wedel
L. Sjöström
Author Affiliation
Departments of Anesthesiology and Intensive Care, University of Göteborg, Göteborg, Sweden. david.sjostrom@medfak.gu.se
Source
Hypertension. 2000 Jul;36(1):20-5
Date
Jul-2000
Language
English
Publication Type
Article
Keywords
Adult
Diabetes Mellitus - epidemiology
Female
Humans
Hypertension - epidemiology
Incidence
Male
Middle Aged
Obesity - complications
Prevalence
Prospective Studies
Research Support, Non-U.S. Gov't
Weight Loss
Abstract
The beneficial effects of weight loss in the obese have been widely accepted. Still, there is a lack of controlled studies displaying large maintained weight losses over long periods (>4 years). We wanted to examine the results of long-standing intentional weight loss on the development of diabetes and hypertension in severely obese individuals over an 8-year period. In the ongoing prospective Swedish Obese Subjects (SOS) study, 346 patients awaiting gastric surgery were matched with 346 obese control subjects on 18 variables by a computerized matching program. The controls were drawn from a registry consisting of 1508 obese potential controls examined at primary health care centers in Sweden. Of the 692 selected patients (body mass index 41.2+/-4.7 kg/m(2) [mean+/-SD]), 483 (70%) were followed for 8 years. No significant weight changes occurred in the obese control group over 8 years. Gastric surgery resulted in a maximum weight loss of -31.1+/-13.6 kg after 1 year. After 8 years, the maintained weight loss was still 20.1+/-15.7 kg (16.3+/-12.3%). Whereas this weight reduction had a dramatic effect on the 8-year incidence of diabetes (odds ratio 0.16, 95% CI 0.07 to 0.36), it had no effect on the 8-year incidence of hypertension (odds ratio 1.01, 95% CI 0.61 to 1.67). A differentiated risk factor response was identified: a maintained weight reduction of 16% strongly counteracted the development of diabetes over 8 years but showed no long-term effect on the incidence of hypertension.
PubMed ID
10904007 View in PubMed
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Effects of bariatric surgery on disability pension in Swedish obese subjects.

https://arctichealth.org/en/permalink/ahliterature136602
Source
Int J Obes (Lond). 2012 Mar;36(3):356-62
Publication Type
Article
Date
Mar-2012
Author
L. Gripeteg
A K Lindroos
M. Peltonen
L. Sjöström
K. Narbro
Author Affiliation
Department of Molecular and Clinical Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Source
Int J Obes (Lond). 2012 Mar;36(3):356-62
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adult
Bariatric Surgery - economics - methods - statistics & numerical data
Disability Evaluation
Disabled persons - statistics & numerical data
Female
Follow-Up Studies
Humans
Incidence
Life Style
Male
Middle Aged
Obesity, Morbid - economics - epidemiology - surgery
Pensions
Prospective Studies
Risk factors
Sweden - epidemiology
Time Factors
Weight Loss
Abstract
Prospective controlled data on the long-term effects of bariatric surgery on disability pension are not available. This study prospectively compare disability pension in surgically and conventionally treated obese men and women.
The Swedish obese subjects study started in 1987 and involved 2010 obese patients who had bariatric surgery and 2037 contemporaneously matched obese controls, who received conventional treatment. Outcomes of this report were: (i) incidence of disability pension from study inclusion to 31 December 2006 in all subjects, and, (ii) number of disability pension days over 10 years in a subgroup of individuals (N=2901) followed for at least 10 years where partial pensions were recalculated to full number of days per year. Objective information on granted disability pension was obtained from the Swedish Social Insurance Agency and disability pension follow-up rate was 99.9%.
In men, the unadjusted incidence of disability pension did not differ between the surgery and control groups (N=156 in both groups). When adjusting for baseline confounders in men, a reduced risk of disability pension was suggested in the surgery group (hazard ratio 0.79, 95% confidence interval 0.62-1.00; P=0.05). Furthermore, the adjusted average number of disability pension days was lower in the surgery group, 609 versus 734 days (P=0.01). In women, bariatric surgery was not associated with significant effects on incidence or number of days of disability pension.
Bariatric surgery may be associated with favourable effects on disability pension for up to 19 years in men whereas neither favourable nor unfavourable effects could be detected in women.
PubMed ID
21364529 View in PubMed
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High-fibre, low-fat diet predicts long-term weight loss and decreased type 2 diabetes risk: the Finnish Diabetes Prevention Study.

https://arctichealth.org/en/permalink/ahliterature170237
Source
Diabetologia. 2006 May;49(5):912-20
Publication Type
Article
Date
May-2006
Author
J. Lindström
M. Peltonen
J G Eriksson
A. Louheranta
M. Fogelholm
M. Uusitupa
J. Tuomilehto
Author Affiliation
Diabetes and Genetic Epidemiology Unit, Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland. jaana.lindstrom@ktl.fi
Source
Diabetologia. 2006 May;49(5):912-20
Date
May-2006
Language
English
Publication Type
Article
Keywords
Counseling
Diabetes Mellitus, Type 2 - epidemiology - prevention & control
Diet, Fat-Restricted
Dietary Fiber
Exercise
Female
Finland - epidemiology
Glucose Intolerance - rehabilitation - therapy
Humans
Male
Risk factors
Weight Loss - physiology
Abstract
The aim of this study was to investigate the association of dietary macronutrient composition and energy density with the change in body weight and waist circumference and diabetes incidence in the Finnish Diabetes Prevention Study.
Overweight, middle-aged men (n=172) and women (n=350) with impaired glucose tolerance were randomised to receive either 'standard care' (control) or intensive dietary and exercise counselling. Baseline and annual examinations included assessment of dietary intake with 3-day food records and diabetes status by repeated 75-g OGTTs. For these analyses the treatment groups were combined and only subjects with follow-up data (n=500) were included.
Individuals with low fat (median) intakes lost more weight compared with those consuming a high-fat (>median), low-fibre (
PubMed ID
16541277 View in PubMed
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The incidence of albuminuria after bariatric surgery and usual care in Swedish Obese Subjects (SOS): a prospective controlled intervention trial.

https://arctichealth.org/en/permalink/ahliterature266375
Source
Int J Obes (Lond). 2015 Jan;39(1):169-75
Publication Type
Article
Date
Jan-2015
Author
L M S Carlsson
S. Romeo
P. Jacobson
M A Burza
C. Maglio
K. Sjöholm
P-A Svensson
B. Haraldsson
M. Peltonen
L. Sjöström
Source
Int J Obes (Lond). 2015 Jan;39(1):169-75
Date
Jan-2015
Language
English
Publication Type
Article
Keywords
Bariatric Surgery
Body mass index
Female
Follow-Up Studies
Humans
Incidence
Intervention Studies
Male
Middle Aged
Obesity, Morbid - complications - epidemiology - surgery
Prospective Studies
Renal insufficiency
Renal Insufficiency, Chronic - epidemiology - etiology - prevention & control
Sweden - epidemiology
Weight Loss
Abstract
Obesity is associated with increased risk of chronic kidney disease and albuminuria is a predictor of renal impairment. Bariatric surgery reduces body weight in obese subjects, but it is not known whether surgery can prevent development of albuminuria. This study aims to determine the long-term effect of bariatric surgery on the incidence of albuminuria.
The Swedish Obese Subjects study is a non-randomized, prospective, controlled study conducted at 25 public surgical departments and 480 primary health care centers in Sweden. Between 1 September 1987 and 31 January 2001, 2010 participants who underwent bariatric surgery and 2037 controls were recruited. Inclusion criteria were age 37-60 years and BMI ? 34 in men and BMI ? 38 in women. In this analysis, we included 1498 patients in the surgery group and 1610 controls without albuminuria at baseline. Patients in the bariatric surgery group underwent banding (18%), vertical banded gastroplasty (69%) or gastric bypass (13%); controls received usual obesity care. Date of analysis was 1 January 2011. Median follow-up was 10 years, and the rates of follow-up were 87%, 74 and 52% at 2, 10 and 15 years, respectively. The main outcome of this report is incidence of albuminuria (defined as urinary albumin excretion >30 mg per 24 h) over up to 15 years.
During the follow-up, albuminuria developed in 246 participants in the control group and in 126 in the bariatric surgery group, corresponding to incidence rates of 20.4 and 9.4 per 1000 person years, respectively (adjusted hazard ratio, 0.37; 95% confidence interval, 0.30-0.47; P
Notes
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PubMed ID
24798033 View in PubMed
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Long-term effects of weight loss on pharmaceutical costs in obese subjects. A report from the SOS intervention study.

https://arctichealth.org/en/permalink/ahliterature47584
Source
Int J Obes Relat Metab Disord. 2002 Feb;26(2):184-92
Publication Type
Article
Date
Feb-2002
Author
G. Agren
K. Narbro
I. Näslund
L. Sjöström
M. Peltonen
Author Affiliation
Department of Surgery, Orebro Medical Centre Hospital, Orebro, Sweden.
Source
Int J Obes Relat Metab Disord. 2002 Feb;26(2):184-92
Date
Feb-2002
Language
English
Publication Type
Article
Keywords
Adult
Antihypertensive Agents - economics
Cardiovascular Diseases - economics - prevention & control
Diabetes Mellitus - economics - prevention & control
Drug Costs
Female
Humans
Hypoglycemic Agents - economics
Longitudinal Studies
Male
Middle Aged
Obesity - diet therapy - economics - surgery
Questionnaires
Registries
Research Support, Non-U.S. Gov't
Sweden
Weight Loss
Abstract
BACKGROUND: Although intentional weight reduction improves obesity-related comorbidities, the associations between weight reduction, medication and related costs are rarely studied. This study investigates the long-term effects of weight change on medication for diabetes and cardiovascular disease (CVD) in severely obese subjects. METHODS: In the intervention study Swedish Obese Subjects, 510 surgically and 455 conventionally treated obese patients have so far been followed for 6 y. Changes in the use and costs of medication were analyzed in relation to treatment and weight change. RESULTS: In comparison with controls, larger fraction of surgically treated patients discontinued the use of medication for CVD and diabetes at 2 and 6 y (risk ratios 0.56-0.77). Among subjects not initially on medication, surgery reduced the frequency of started treatments (risk ratios 0.08-0.80). Relative weight loss >or=10% was necessary to reduce costs of medication for CVD and diabetes among subjects with such treatment at baseline. To reduce initiation of new treatment against the two conditions, weight loss >or=15% was required. Over 6 y, the average annual cost for diabetes and CVD medication increased by 463 SEK (96%) in subjects with weight loss or=15%. CONCLUSION: Long-term intentional weight loss is associated with reduced medication and medication costs for diabetes and CVD. The effects appear to be more marked among subjects who are initially on medication for these conditions, whereas greater weight reduction is needed to prevent new subjects from starting on medication.
PubMed ID
11850749 View in PubMed
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Two-year outcome of laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity: results from a Swedish Nationwide Study (AMOS).

https://arctichealth.org/en/permalink/ahliterature120418
Source
Int J Obes (Lond). 2012 Nov;36(11):1388-95
Publication Type
Article
Date
Nov-2012
Author
T. Olbers
E. Gronowitz
M. Werling
S. Mårlid
C-E Flodmark
M. Peltonen
G. Göthberg
J. Karlsson
K. Ekbom
L V Sjöström
J. Dahlgren
H. Lönroth
P. Friberg
C. Marcus
Author Affiliation
Department of Surgery, Sahlgrenska Academy at University of Gothenburg, Medicine, Clinical Physiology and Paediatrics (Queen Silvia Children's Hospital), Gothenburg, Sweden. torsten.olbers@gmail.com
Source
Int J Obes (Lond). 2012 Nov;36(11):1388-95
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Body mass index
Female
Follow-Up Studies
Gastric Bypass - methods - psychology - rehabilitation
Humans
Intervention Studies
Laparoscopy - methods - psychology - rehabilitation
Male
Obesity, Morbid - epidemiology - psychology - surgery
Postoperative Complications - epidemiology - psychology - rehabilitation
Prevalence
Quality of Life
Risk factors
Sweden - epidemiology
Treatment Outcome
Weight Loss
Abstract
The prevalence of obesity among adolescents has increased and we lack effective treatments.
To determine if gastric bypass is safe and effective for an unselected cohort of adolescents with morbid obesity in specialized health care.
Intervention study for 81 adolescents (13-18 years) with a body mass index (BMI) range 36-69 kg?m(-2) undergoing laparoscopic gastric bypass surgery in a university hospital setting in Sweden between April 2006 and May 2009. For weight change comparisons, we identified an adult group undergoing gastric bypass surgery (n=81) and an adolescent group (n=81) receiving conventional care.
Two-year outcome regarding BMI in all groups, and metabolic risk factors and quality of life in the adolescent surgery group.
Two-year follow-up rate was 100% in both surgery groups and 73% in the adolescent comparison group. In adolescents undergoing surgery, BMI was 45.5 ± 6.1 (mean ± s.d.) at baseline and 30.2 (confidence interval 29.1-31.3) after 2 years (P20 mU?l(-1)) was present in 70% of the adolescent surgery patients, which was reduced to 0% at 1 year and 3% at 2 years. Other cardiovascular risk factors were also improved. Two-thirds of adolescents undergoing surgery had a history of psychopathology. Nevertheless, the treatment was generally well tolerated and, overall, quality of life increased significantly. Adverse events were seen in 33% of patients.
Adolescents with severe obesity demonstrated similar weight loss as adults following gastric bypass surgery yet demonstrating high prevalence of psychopathology at baseline. There were associated benefits for health and quality of life. Surgical and psychological challenges during follow-up require careful attention.
PubMed ID
23007037 View in PubMed
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7 records – page 1 of 1.