| 26401. |
- Dahlquist, Gisela, et al.
(författare)
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Early neonatal events and the disease incidence in nonobese diabetic mice.
- 1997
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Ingår i: Pediatric Research. - 0031-3998 .- 1530-0447. ; 42:4, s. 489-91
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Tidskriftsartikel (refereegranskat)abstract
- Epidemiologic studies have shown that perinatal events are associated with an increased risk for type 1 (insulin-dependent) diabetes in childhood. We used nonobese diabetic mice to examine whether neonatal separation from the mother with or without phototherapy would affect the incidence of diabetes in this genetically susceptible mouse model. The newborn pups were taken from their mothers for two 4-h periods during each of five successive days. One group of animals was just taken from their mothers and were left lying in daylight in the cage, whereas another group was exposed to identical light as used for treatment of neonatal jaundice in infants. Treatment resulted in a 30% death rate. For animals surviving more than 3 mo the incidence of diabetes was significantly higher in both treatment groups compared with control animals, allowed to stay with their mother. The odds ratio for treatment versus control, stratifying for sex, was 3.42 (95% confidence interval, 1.57-7.74). Histologic insulitis did not differ between treated and untreated animals when examined either at clinical diabetes onset or at 8 mo of age. Blood glucose values at 8 mo of age (in animals without clinical diabetes) did not differ between-treated and untreated animals. It is concluded that neonatal separation of the nonobese diabetic mice from their mothers will lead to a significantly increased risk for diabetes. This increase in risk seems to be associated with the induction of metabolic alterations leading to increased peripheral insulin need rather than with an increased rate of beta cell destruction.
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| 26402. |
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| 26403. |
- Dahlquist, Gisela
(författare)
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[Fetal virus infection a risk factor of diabetes mellitus type 1 in children].
- 2000
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 97:4, s. 313-5
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Tidskriftsartikel (refereegranskat)abstract
- The incidence of type-1 diabetes mellitus is high and increasing in Sweden. The etiology of IDDM is complex: several genes appear to interact with each other and with various nongenetic risk factors to induce and complete the autoimmune destruction of beta-cells. IDDM has its onset most often in childhood, and during the past decade incidence is increasing specifically among children under the age of five. Factors initiating the process should thus be sought in early life. A number of recent studies have identified perinatal events as risk determinants; among these, fetal viral infections may be causally related to the disease and may become targets for intervention and prevention.
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| 26404. |
- Dahlquist, G G, et al.
(författare)
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Birthweight and risk of type 1 diabetes in children and young adults : a population-based register study.
- 2005
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Ingår i: Diabetologia. - 0012-186X. ; 48:6, s. 1114-7
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Tidskriftsartikel (refereegranskat)abstract
- AIMS/HYPOTHESIS: We investigated the association between type 1 diabetes and birthweight by age at disease onset. METHODS: This population-based case-referent study used data from two nationwide case registers that are linked to the Swedish Medical Birth Registry and cover incident cases of type 1 diabetes in the 0- to 14-year (since 1 July 1977) and 15- to 34-year age groups (since 1 January 1983). Of the cases linked to the Medical Birth Registry, a total of 9,283 cases with onset before 15 years of age was recorded before 1 January 2003, and 1,610 cases were recorded with onset before 30 years of age and born after 1973 (together 95% of eligible cases). Multiple births and babies of diabetic mothers were excluded. Sex-specific birthweight by gestational week is expressed as multiples of the standard deviation (SDS) and adjusted for year of birth, maternal age and parity. RESULTS: Cases with onset before 10 years of age (n = 5,792) showed a significant linear trend in odds ratio (OR) by SDS of adjusted birthweight (OR by SDS: 0.062; 95% CI: 0.037-0.086; p < 0.0001), while cases with onset at the age of 10-29 years showed no significant trend (OR by SDS: 0.004; 95% CI: -0.007 to 0.0014; p = 0.22). CONCLUSIONS/INTERPRETATION: The association between type 1 diabetes risk and birthweight seems to be limited to cases with disease onset in younger years.
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| 26405. |
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| 26406. |
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| 26407. |
- Dahlquist, G G
(författare)
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Primary and secondary prevention strategies of pre-type 1 diabetes. Potentials and pitfalls.
- 1999
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Ingår i: Diabetes Care. - 0149-5992 .- 1935-5548. ; 22 Suppl 2, s. B4-6
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Tidskriftsartikel (refereegranskat)abstract
- Over the past decade, a large part of type 1 diabetes research has focused on the possibility of preventing the disease. The objective of this article is to analyze which potential and pitfalls different preventive strategies may involve from the individual, epidemiological, and ethical perspectives. Two potential prevention strategies are considered: l) to try to arrest or delay an already ongoing immune destruction of the beta-cells, and 2) to try to intervene with exposures that may initiate this process. In addition to the potential effects of immune modulation, this prevention strategy depends on screening for risk markers. There are inherent ethical problems with screening because of the introduction of awareness of risk in healthy individuals and also because false positivity, the rate of which differs tremendously in high- and low-risk groups. Because of these latter circumstances, the most promising low-risk preventive treatments presently used in trials, i.e., nicotinamide and insulin, will probably only be feasible in high-risk groups, such as family members, though this group covers only 10-15% of potential cases. The second strategy aiming at eradicating environmental initiators of the beta-cell destruction will avoid the problem of screening and approach a total population at risk. Potential risk factors, such as food components (cow's milk proteins, gliadin or nitroso products) or different viruses, are indicated by animal and epidemiological studies. So far, however, no single environmental risk factor has been proven to be necessary and certainly not sufficient for the disease causation, and the etiological fractions estimated in population-based studies are low. It is concluded that more basic research is warranted before effective and safe prevention can be introduced for type 1 diabetes. Most probably, different preventive strategies must be applied to different groups and populations and in different phases of the beta-cell destruction.
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| 26408. |
- Dahlquist, Gisela
(författare)
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Hippokrates i vår tid
- 2011
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Ingår i: Läkartidningen. - Stockholm : Sveriges läkarförbund. - 0023-7205 .- 1652-7518. ; 108:47, s. 2438-2440
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Tidskriftsartikel (refereegranskat)abstract
- Hippocrates, the controversial but outstanding innovator both of our views on clinical medicine and of our role as doctors is an important idol also in our time. The interests of the weakest groups must be defended in medical research as well as in clinical medicine and ethics must have a self- evident place in everyday patient care as well as in education and research. We as doctors must keep up the debate between us but also with the stake holders to communicate insights about the needs of the weakest. We must help others to see those who cannot themselves maintain their rights to equality in health care in our dynamic time.
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| 26409. |
- Dahlquist, Gisela, et al.
(författare)
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Incidence of Type 1 Diabetes in Sweden Among Individuals Aged 0-34 Years, 1983-2007 : An analysis of time trends
- 2011
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Ingår i: Diabetes Care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 34:8, s. 1754-1759
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To clarify whether the increase in childhood type 1 diabetes is mirrored by a decrease in older age-groups, resulting in younger age at diagnosis.Research design and methods: We used data from two prospective research registers, the Swedish Childhood Diabetes Register, which included case subjects aged 0–14.9 years at diagnosis, and the Diabetes in Sweden Study, which included case subjects aged 15–34.9 years at diagnosis, covering birth cohorts between 1948 and 2007. The total database included 20,249 individuals with diabetes diagnosed between 1983 and 2007. Incidence rates over time were analyzed using Poisson regression models.Results: The overall yearly incidence rose to a peak of 42.3 per 100,000 person-years in male subjects aged 10–14 years and to a peak of 37.1 per 100,000 person-years in female subjects aged 5–9 years and decreased thereafter. There was a significant increase by calendar year in both sexes in the three age-groups <15 years; however, there were significant decreases in the older age-groups (25- to 29-years and 30- to 34-years age-groups). Poisson regression analyses showed that a cohort effect seemed to dominate over a time-period effect.Conclusions: Twenty-five years of prospective nationwide incidence registration demonstrates a clear shift to younger age at onset rather than a uniform increase in incidence rates across all age-groups. The dominance of cohort effects over period effects suggests that exposures affecting young children may be responsible for the increasing incidence in the younger age-groups.
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| 26410. |
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