umu.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Clinical and genetic determinants of progression of type 2 diabetes: a DIRECT study
Division of Cardiovascular & Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, U.K..
Division of Cardiovascular & Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, U.K..
Division of Cardiovascular & Diabetes Medicine, Medical Research Institute, University of Dundee, Dundee, U.K..
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Department of Clinical Science, Genetic & Molecular Epidemiology Unit, Lund University, Malmö, Sweden ; Department of Nutrition, Harvard University, School of Public Health, Boston, MA.
Show others and affiliations
2014 (English)In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 37, no 3, 718-724 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To identify the clinical and genetic factors that explain why the rate of diabetes progression is highly variable between idividuals following diagnosis of type 2 diabetes.

RESEARCH DESIGN AND METHODS: We studied 5,250 patients with type 2 diabetes using comprehensive electronic medical records in Tayside, Scotland, from 1992 onward. We investigated the association of clinical, biochemical, and genetic factors with the risk of progression of type 2 diabetes from diagnosis to the requirement of insulin treatment (defined as insulin treatment or HbA(1c) 8.5% [69 mmol/mol] treated with two or more noninsulin therapies).RESULTSRisk of progression was associated with both low and high BMI. In an analysis stratified by BMI and HbA(1c) at diagnosis, faster progression was independently associated with younger age at diagnosis, higher log triacylglyceride (TG) concentrations (hazard ratio [HR] 1.28 per mmol/L [95% CI 1.15-1.42]) and lower HDL concentrations (HR 0.70 per mmol/L [95% CI 0.55-0.87]). A high Genetic Risk Score derived from 61 diabetes risk variants was associated with a younger age at diagnosis and a younger age when starting insulin but was not associated with the progression rate from diabetes to the requirement of insulin treatment.

CONCLUSIONS: Increased TG and low HDL levels are independently associated with increased rate of progression of diabetes. The genetic factors that predispose to diabetes are different from those that cause rapid progression of diabetes, suggesting a difference in biological process that needs further investigation.

Place, publisher, year, edition, pages
American Diabetes Association , 2014. Vol. 37, no 3, 718-724 p.
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:umu:diva-89240DOI: 10.2337/dc13-1995ISI: 000331708600027OAI: oai:DiVA.org:umu-89240DiVA: diva2:719674
Available from: 2014-05-26 Created: 2014-05-26 Last updated: 2017-12-05Bibliographically approved

Open Access in DiVA

fulltext(732 kB)156 downloads
File information
File name FULLTEXT01.pdfFile size 732 kBChecksum SHA-512
8f229f5feaa5fab82a4f90d4320bd48f6327ddee772ac93a8fd5cd363f1368afae2498f9758830645ef5c8272f7848f00e095aafb5d1d277a9e1ba386b114f11
Type fulltextMimetype application/pdf

Other links

Publisher's full text

Authority records BETA

Franks, Paul W.

Search in DiVA

By author/editor
Franks, Paul W.
By organisation
Medicine
In the same journal
Diabetes Care
Endocrinology and Diabetes

Search outside of DiVA

GoogleGoogle Scholar
Total: 156 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 84 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf