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  • 1. Bennet, Louise
    et al.
    Groop, Leif
    Franks, Paul W.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. Department of Nutrition, Harvard School of Public Health, Boston, MA, USA; Department of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden; Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Malmö, Sweden.
    Country of birth modifies the association of fatty liver index with insulin action in Middle Eastern immigrants to Sweden2015In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 110, no 1, p. 66-74Article in journal (Refereed)
    Abstract [en]

    Aims: Non-alcohol fatty liver disease (NAFLD) is a strong risk factor for insulin resistance and type 2 diabetes. The prevalence of NAFLD varies across populations of different ethnic backgrounds but the prevalence in Middle Eastern populations, which are at high risk of type 2 diabetes, is largely unknown. Using fatty liver index (FLI) as a proxy for NAFLD the aim was to calculate the odds of NAFLD (FLI >= 70) given country of origin and further to investigate the associations between ISI and FLI. Methods: In 2010-2012 we conducted a population-based study of individuals aged 30-75 years born in Iraq or Sweden, in whom anthropometrics, fasting blood samples and oral glucose tolerance tests were performed and sociodemography and lifestyle behaviors characterized. Results: A higher proportion of Iraqis (N = 1085) than Swedes (N = 605) had a high probability of NAFLD (FLI >= 70, 32.5 vs. 22.6%, p < 0.001, age-and sex-adjusted data) and ISI was more severely impaired (70.7 vs. 95.9%, p < 0.001). Independently of traditional risk factors for NAFLD, being born in Iraqi increased the risk of FLI >= 70 (OR 1.59: 95% CI 1.15, 2.20). Furthermore, country of birth presented a stronger association between ISI and FLI >= 70 in Iraqis than in Swedes (P-interaction = 0.019). Conclusions: Our data indicate that immigrants from Iraq are at higher risk of NAFLD. The finding that country of birth modifies the relationship of FLI with ISI, suggests that liver fat may be a stronger determinant of impaired insulin action and increased risk of type 2 diabetes in Iraqis than in Swedes.

  • 2. Bennet, Louise
    et al.
    Groop, Leif
    Franks, Paul W
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Ethnic differences in the contribution of insulin action and secretion to type 2 diabetes in immigrants from the Middle East compared to native Swedes2014In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 105, no 1, p. 79-87Article in journal (Refereed)
    Abstract [en]

    Aims: We investigated insulin action (insulin sensitivity index, ISI) and insulin secretion (oral disposition indices, DIo) and studied metabolic, demographic and lifestyle-related risk factors for type 2 diabetes and insulin action, in the largest non-European immigrant group to Sweden, immigrants from Iraq and native Swedes.

    Methods: Population-based, cross-sectional study conducted 2010-2012 including residents 30-75 years of age born in Iraq or Sweden, in whom oral glucose tolerance tests were performed and sociodemography and lifestyle behaviors were characterized.

    Results: In Iraqis compared to Swedes, ISI was more impaired (76.9 vs. 102.3, p < .001) whereas corrected insulin response CIR was higher (226.6 vs. 188.6, p = .016). However, insulin secretion was inadequate given the substantial insulin resistance, as indicated by lower DIo indices in Iraqis than in Swedes (DIo 12,712.9 vs. 14,659.2, p < .001). The crude ethnic difference in ISI was not offset by traditional risk factors like waist circumference, body mass index or family history of diabetes. In Iraqis, ISI conveyed somewhat higher odds of type 2 diabetes than in Swedes (odds ratio OR 0.98, 95% CI 0.97-0.99) vs. OR 0.95, 0.92-0.99), as indicated by an interaction between country of birth and ISI (P-interaction = .044).

    Conclusion: This study reports ethnic differences in the contribution of insulin action to type 2 diabetes. Our data suggests that the impaired insulin action observed in immigrants from the Middle East to Sweden is not fully explained by established risk factors.

    (C) 2014 The Authors. Published by Elsevier Ireland Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).

  • 3. Hadaegh, Farzad
    et al.
    Ghasemi, Asghar
    Padyab, Mojgan
    Tohidi, Maryam
    Azizi, Fereidoun
    The metabolic syndrome and incident diabetes: Assessmentof alternative definitions of the metabolic syndrome in anIranian urban population2008In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227Article in journal (Refereed)
    Abstract [en]

    Aims: To compare the ability of definitions of Metabolic Syndrome (MetS) in the predictionof type 2 diabetes.Methods: We examined 4756 subjects in an Iranian population who were non-diabetic atbaseline. After 3.6 years, 188 individuals developed diabetes.Results: Impaired glucose tolerance (IGT) and MetS definitions predicted type 2 diabetes withodds ratios ranging from 3.7 to 11.9 (all P < 0.05) although IGT had the highest area under thereceiver operator characteristic (aROC) curve than all the MetS definitions. Reduction ofglucose in the National Cholesterol Education Program (NCEP) definition of the MetSincreased diabetes prediction, but adding the family history of diabetes did not changeaROC curves. The International Diabetes Federation (IDF) definition had the highest sensitivityand false positive rate (72.2 and 35.1%, respectively) and the WHO definition had thelowest ones (54.8 and 9.2%, respectively) for predicting diabetes. The positive predictivevalues of all definitions were low (8.6–19.7%) but their negative predictive values werearound 98%.Conclusions: In Iranian population, the MetS was inferior to IGT for predicting type 2diabetes. The NCEP definition of the MetS with reduced level of glucose (not includingthe family history of diabetes) and IDF definition predicted type 2 diabetes at least as well asWHO definition.

  • 4.
    Hörnsten, Åsa
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lundman, Berit
    Umeå University, Faculty of Medicine, Department of Nursing.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Sandström, Herbert
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Metabolic improvement after intervention focusing on personal understanding in type 2 diabetes.2005In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 68, no 1, p. 65-74Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to evaluate, whether an educational intervention, focusing on patients' personal understanding of their illness, was more effective than care given according to national guidelines for diabetes care. METHODS: An intervention group (n = 44), with type 2 diabetes was compared with a control group (n = 60), with HbA1c as the primary outcome. The intervention included ten group sessions addressing themes related to the patients' personal understanding of their illness. The diabetes nurses involved were educated in theories about illness/wellness experiences and participated in group sessions where various caring strategies related to the patients' individual needs and understanding were reflected upon. RESULTS: At 1-year follow-up the intervention group showed lower HbA1c levels (mean difference 0.94%; P < 0.001), lower triglycerides (mean difference 0.52 mmol/l; P = 0.002) and higher high-density lipoprotein (mean difference 0.15 mmol/l; P = 0.029) and treatment satisfaction than did the control group. The differences remained when adjusting for age, gender, body mass index or changed treatment during the intervention period. Within the intervention group, BMI and treatment satisfaction were also improved. CONCLUSION: The intervention, which focused on patients' personal understanding of illness, was found to be effective in terms of metabolic control and treatment satisfaction.

  • 5.
    Hörnsten, Åsa
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Lundman, Berit
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sandström, Herbert
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine. Allmänmedicin.
    Improvements in HbA1c remain after 5 years--a follow up of an educational intervention focusing on patients' personal understandings of type 2 diabetes2008In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 81, no 1, p. 50-5Article in journal (Refereed)
    Abstract [en]

    This paper reports a 5-year follow-up from a study aimed at evaluating whether an intervention which focused on patients’ personal understanding of their illness was more effective than conventional diabetes care with regard to metabolic control among patients with type 2 diabetes mellitus (DM2). The study was conducted within Swedish primary health care and included 102 patients (mean age 63 years). At clinic level they were randomised into control or intervention groups. The intervention directed at patients consisted of ten two-hour group sessions over 9 months, focusing on patients’ own needs and questions. The mean HbA1c at baseline was 5.71% (S.D. 0.76) in the intervention group and 5.78% (S.D. 0.71) in the control group. At the 5-year follow-up, the mean HbA1c in the intervention group still was 5.71% (S.D. 0.85) while among the controls it had increased to 7.08% (S.D. 1.71). The adjusted difference was 1.37 (p < 0.0001). Treatment upgrade, BMI, total cholesterol, HDL, LDL and triglycerides at baseline did not influence the difference in HbA1c. These findings indicate that group sessions in patients with DM2 focusing on patients’ personal understanding of their illness are more effective than conventional diabetes care with regard to metabolic control.

  • 6. Lee, Crystal Man Ying
    et al.
    Woodward, Mark
    Pandeya, Nirmala
    Adams, Robert
    Barrett-Connor, Elizabeth
    Boyko, Edward J.
    Eliasson, Mats
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Franco, Laercio J.
    Fujimoto, Wilfred Y.
    Gonzalez, Clicerio
    Howard, Barbara V.
    Jacobs, David R., Jr.
    Keinanen-Kiukaanniemi, Sirkka
    Magliano, Dianna
    Schreiner, Pamela
    Shaw, Jonathan E.
    Stevens, June
    Taylor, Anne
    Tuomilehto, Jaakko
    Wagenknecht, Lynne
    Huxley, Rachel R.
    Comparison of relationships between four common anthropometric measures and incident diabetes2017In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 132, p. 36-44Article in journal (Refereed)
    Abstract [en]

    Aims: First, to conduct a detailed exploration of the prospective relations between four commonly used anthropometric measures with incident diabetes and to examine their consistency across different population subgroups. Second, to compare the ability of each of the measures to predict five-year risk of diabetes. Methods: We conducted a meta- analysis of individual participant data on body mass index (BMI), waist circumference (WC), waist- hip and waist- height ratio (WHtR) from the Obesity, Diabetes and Cardiovascular Disease Collaboration. Cox proportional hazard models were used to estimate the association between a one standard deviation increment in each anthropometric measure and incident diabetes. Harrell's concordance statistic was used to test the predictive accuracy of each measure for diabetes risk at five years. Results: Twenty- one studies with 154,998 participants and 9342 cases of incident diabetes were available. Each of the measures had a positive association with incident diabetes. A one standard deviation increment in each of the measures was associated with 64- 80% higher diabetes risk. WC and WHtR more strongly associated with risk than BMI (ratio of hazard ratios: 0.95 [0.92,0.99] - 0.97 [0.95,0.98]) but there was no appreciable difference between the four measures in the predictive accuracy for diabetes at five years. Conclusions: Despite suggestions that abdominal measures of obesity have stronger associations with incident diabetes and better predictive accuracy than BMI, we found no overall advantage in any one measure at discriminating the risk of developing diabetes. Any of these measures would suffice to assist in primary diabetes prevention efforts.

  • 7. Nan, Hairong
    et al.
    Qiao, Qing
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine. International Diabetes Institute, Melbourne, Australia.
    Pitkäniemi, Janne
    Zimmet, Paul
    Shaw, Jonathan
    Alberti, George
    Uusitalo, Ulla
    Pauvaday, Vassen
    Chitson, Pierrot
    Tuomilehto, Jaakko
    Serum uric acid and incident diabetes in Mauritian Indian and Creole populations2008In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 80, no 2, p. 321-327Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the predictive value of serum uric acid (UA) for the development of diabetes in Asian Indians and Creoles living in Mauritius.

    Methods: A total of 1941 men (1409 Indians, 532 Creoles) and 2318 non-pregnant women (1645 Indians, 673 Creoles), aged 25–74 years and free of diabetes, cardiovascular disease and gout at baseline examinations in 1987 or 1992, were re-examined in 1992 and/or 1998. Diabetes was determined according to WHO/IDF 2006 criteria. The relationship between baseline UA and the development of diabetes during the follow-up was estimated using interval censored survival analysis.

    Results: In this cohort 337 (17.4%) men and 379 (16.4%) women developed diabetes during the follow-up. Individuals who developed diabetes during the follow-up had a lower serum UA levels at follow-up compared with their baseline UA levels, but this is not observed for post-menopausal women. Multivariate adjusted hazard ratios (HRs) (95% CIs) for the development of diabetes corresponding to one S.D. increase in UA concentration at baseline were 1.14 (1.01, 1.30) in Indian men and 1.37 (1.11, 1.68) in Creole men. They were 1.07 (0.95, 1.22) and 1.01 (0.84, 1.22), respectively, in Indians and Creole women.

    Conclusion: Elevated serum UA is an independent risk marker for future diabetes in Mauritian men, whereas the prediction is weak in women.

  • 8.
    Norberg, Margareta
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Lindahl, B
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Andersson, Christer
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Eriksson, Jan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Weinehall, Lars
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.
    Work stress and low emotional support is associated with increased risk of future type 2 diabetes in women2007In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 76, no 3, p. 368-377Article in journal (Refereed)
    Abstract [en]

    A case-referent study nested within a population-based health survey investigated the associations between psychosocial stress, such as work stress and low emotional support, and future development of type 2 diabetes among occupationally working middle-aged men and women. All participants in a health survey conducted during 1989-2000 (n=33,336) in Umeå in northern Sweden, were included. We identified 191 cases, who were not diabetic initially but were diagnosed with type 2 diabetes after 5.4+/-2.6 years. Two age- and sex-matched referents were selected for each case. Multivariate logistic regression analyses and interaction effects between variables were evaluated.

    In women, passive or tense working situations were associated with future type 2 diabetes with odds ratios 3.6 (95% confidence interval 1.1-11.7) and 3.6 (1.0-13.3), respectively, and also low emotional support 3.0 (1.3-7.0). These associations were not seen in men. In women, they remained after adjustment for BMI, civil status and educational level, and there were also tendencies for interactions between work stress and low emotional support.

    In conclusion, work stress and low emotional support may increase the risk of type 2 diabetes in women, but not in men. These findings contribute to our understanding of psychosocial stress as potential risk factors for type 2 diabetes in a Swedish population.

  • 9. Patterson, Chris
    et al.
    Guariguata, Leonor
    Dahlquist, Gisela
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
    Soltész, Gyula
    Ogle, Graham
    Silink, Martin
    Diabetes in the young - a global view and worldwide estimates of numbers of children with type 1 diabetes2014In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 103, no 2, p. 161-175Article in journal (Refereed)
    Abstract [en]

    This paper describes the methodology, results and limitations of the 2013 International Diabetes Federation (IDF) Atlas (6th edition) estimates of the worldwide numbers of prevalent cases of type 1 diabetes in children (<15 years). The majority of relevant information in the published literature is in the form of incidence rates derived from registers of newly diagnosed cases. Studies were graded on quality criteria and, if no information was available in the published literature, extrapolation was used to assign a country the rate from an adjacent country with similar characteristics. Prevalence rates were then derived from these incidence rates and applied to United Nations 2012 Revision population estimates for 2013 for each country to obtain estimates of the number of prevalent cases. Data availability was highest for the countries in Europe (76%) and lowest for the countries in sub-Saharan Africa (8%). The prevalence estimates indicate that there are almost 500,000 children aged under 15 years with type 1 diabetes worldwide, the largest numbers being in Europe (129,000) and North America (108,700). Countries with the highest estimated numbers of new cases annually were the United States (13,000), India (10,900) and Brazil (5000). Compared with the prevalence estimates made in previous editions of the IDF Diabetes Atlas, the numbers have increased in most of the IDF Regions, often reflecting the incidence rate increases that have been well-documented in many countries. Monogenic diabetes is increasingly being recognised among those with clinical features of type 1 or type 2 diabetes as genetic studies become available, but population-based data on incidence and prevalence show wide variation due to lack of standardisation in the studies. Similarly, studies on type 2 diabetes in childhood suggest increased incidence and prevalence in many countries, especially in Indigenous peoples and ethnic minorities, but detailed population-based studies remain limited.

  • 10. Rambod, Mehdi
    et al.
    Hosseinpanah, Farhad
    Ardakani, Emad
    Padyab, Mojgan
    Azizi, Fereidoun
    Fine-tuning of prediction of isolated impaired glucosetolerance: A quantitative clinical prediction model2008In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227Article in journal (Refereed)
    Abstract [en]

    In this cross-sectional study, we evaluated results of oral glucose tolerance test (OGTT) from4742 women and 3470 men, participated in the Tehran Lipid and Glucose Study, aged 20years and without diabetes, to determine the diagnostic value of subjects’ clinical traits withisolated impaired glucose tolerance (isolated-IGT) defined as fasting plasma glucose (FPG)<5.6 mmol/L and 2-h plasma glucose between 7.8 and 11.1 mmol/L. The overall prevalenceof IGT was 13.6% (n = 1120); of these subjects, 59.6% (n = 668) had isolated-IGT. The adjustedodds ratios for having isolated-IGT among 7012 subjects with FPG <5.6 mmol/L weresignificant for age 40 years (2.5), hypertension (1.9), abnormal waist circumference (1.9),obesity (1.5), and family history of diabetes (1.3). Adding the lipid profiles to the clinicalmodel increased the area under the ROC curve only slightly (73.2% vs. 72.1%, respectively;P = 0.002). In summary, this study showed that in adults with FPG <5.6 mmol/L, older age,family history of diabetes, abnormal waist circumference and obesity, and hypertensionwere significantly associated with a higher likelihood of isolated-IGT; OGTT could hence berecommended in subjects who have most of these characteristics to find Isolated-IGT,especially if the findings are supported by appropriately designed clinical trials.

  • 11. Tan, K
    et al.
    Koshkina, V
    Barr, E
    Ma, S
    Kowlessur, S
    Magliano, D
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Chia, K S
    Zimmet, P
    Lim, W -Y
    Diabetes mellitus prevalence in ethnic Chinese and Indians in Singapore and Mauritius2014In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 106, p. S233-S233Article in journal (Other academic)
  • 12. Tapp, Robyn J
    et al.
    Zimmet, Paul Z
    Harper, C Alex
    McCarty, Daniel J
    Chitson, Pierrot
    Tonkin, Andrew M
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Public Health and Clinical Medicine.
    Taylor, Hugh R
    Alberti, K G M M
    Tuomilehto, Jaakko
    Shaw, Jonathan E
    Six year incidence and progression of diabetic retinopathy: results from the Mauritius diabetes complication study.2006In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 73, no 3, p. 298-303Article in journal (Refereed)
  • 13. Tyrberg, M.
    et al.
    Nyström, Lennarth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Arnqvist, H. J.
    Bolinder, J.
    Gudbjörnsdottir, S.
    Landin-Olsson, M.
    Eriksson, J. W.
    Svensson, M. K.
    Overweight, hyperglycemia and tobacco use are modifiable risk factors for onset of retinopathy 9 and 17 years after the diagnosis of diabetes: a retrospective observational nation-wide cohort study2017In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 133, p. 21-29Article in journal (Refereed)
    Abstract [en]

    Background: The aims of this study were to estimate the risk for diabetic retinopathy (DR) and to identify risk factors. We investigated a nationwide population-based cohort with diabetes diagnosed at age 15-34 years.

    Patients and methods: Of 794 patients registered 1987-1988 in the Diabetes Incidence Study in Sweden (DISS) 444 (56%) patients with retinal photos available for classification of retinopathy participated in a follow-up study 15-19 (median 17) years after diagnosis. Mean age was 42.3 +/- 5.7 years, BMI 26.1 +/- 4.1 kg/m(2), 62% were male and 91% had type 1 diabetes. A sub-study was performed in 367 patients with retinal photos from both the 9 and 17 year follow up and the risk for development of retinopathy between 9 and 17 years of follow up was calculated.

    Results: After median 17 years 324/444 (73%, 67% of T1D and 71% of T2D), had developed any DR but only 5.4% proliferative DR. Male sex increased the risk of developing retinopathy (OR 1.9, 95% CI 1.2-2.9). In the sub-study obesity (OR 1.2, 95% CI 1.04-1.4), hyperglycemia (OR 2.5, 95% CI 1.6-3.8) and tobacco use (OR 2.9, 95% CI 1.1-7.3) predicted onset of retinopathy between 9 and 17 years after diagnosis of diabetes.

    Conclusion: The number of patients with severe retinopathy after 17 years of diabetes disease was small. The risk of developing retinopathy with onset between 9 and 17 years after diagnosis of diabetes was strongly associated to modifiable risk factors such as glycemic control, obesity and tobacco use.

  • 14. Wahlberg, Jeanette
    et al.
    Ekman, Bertil
    Nyström, Lennarth
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Hanson, Ulf
    Persson, Bengt
    Arnqvist, Hans J.
    Gestational diabetes: Glycaemic predictors for fetal macrosomia and maternal risk of future diabetes2016In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 114, p. 99-105Article in journal (Refereed)
    Abstract [en]

    Aims: To investigate how glucose levels at diagnosis of gestational diabetes (GDM) are associated with infant birth weight and long-term risk of manifest diabetes mellitus in the mother. Methods: In a case control study GDM pregnancies (n = 2085) were compared with non-GDM pregnancies matched for day of delivery and obstetric unit (n = 3792). GDM was defined as capillary blood glucose (cB-glucose) >9.0 mmol/l (plasma glucose >10.0 mmol/l) after a 75 g oral glucose tolerance test (OGTT). The GDM cohort were followed up 8.5-13.5 yrs after initial diagnosis with a questionnaire, answered by 1324 GDM women (65%). Results: GDM women had higher mean infant birth-weight compared with controls (3682 g vs. 3541 g, P < 0.001). In multiple linear regression analysis, birth weight was positively correlated to fasting cB-glucose at GDM diagnosis (P < 0.001), increased week of gestation (P < 0.001) and BMI before pregnancy (P < 0.003), while 2 h OGTT cB-glucose values >= 9.0 mmol/l were not related. Infants born to mothers with fasting cB-glucose >= 4.5 mmol/l had no increased mean birth-weight or macrosomia (>= 4500 g) compared to controls. In the follow up 334/1324 women (25%) of the GDM women had developed diabetes, 215 type 2 diabetes, 46 type 1 diabetes and 72 unclassified diabetes. In logistic regression fasting cB-glucose and 2 h OGTT cB-glucose at diagnosis of GDM as well as BMI >25 and origin outside Europe were risk factors for manifest diabetes. Conclusions: Fasting blood glucose at diagnosis of GDM gives important information besides 2 h OGTT glucose about pregnancy outcome and future risk for maternal diabetes.

  • 15. Zhang, Lei
    et al.
    Qiao, Qing
    Laatikainen, Tiina
    Söderberg, Stefan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Jousilahti, Pekka
    Onat, Altan
    Nilsson, Peter
    Tuomilehto, Jaakko
    The impact of dyslipidaemia on incidence of coronary heart disease in Finns and Swedes with different categories of glucose tolerance2011In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 91, no 3, p. 406-412Article in journal (Refereed)
    Abstract [en]

    Background: The association of dyslipidaemia with incidence of coronary heart disease (CHD) has not been well studied in people with different glucose categories.

    Methods: Data from six population-based prospective studies in Finland and Sweden, with 4818 men and 4269 women aged 25–89 years who were free of CHD and without a prior history of diabetes at baseline, were jointly analysed. Multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for CHD incidence were estimated.

    Results: 457 participants developed CHD during follow-up of 10 years. The multivariate adjusted HRs (95% CIs) for CHD incidence were 1.39 (1.08–1.80), 0.57 (0.39–0.84), 1.21 (1.07–1.37), 1.56 (1.21–2.01) and 1.74 (1.34–2.26), respectively, corresponding to a one unit increase in Z-scores of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), non-HDL-C and TC to HDL ratio, in people with newly diagnosed diabetes. The prediction was also significant in non-diabetic population except for TG in individuals with normoglycaemia and TG and HDL-C in those with isolated IFG.

    Conclusion: Adverse lipid profiles were related to increased CHD incidence in normoglycaemic, fasting hyperglycaemic and diabetic individuals, but not in people with IGT. The findings may imply considering different management strategies in people with fasting or post-load hyperglycaemia.

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