| 1. |
- Dybjer, Elin, et al.
(författare)
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Diabetes, kognition och demens
- 2019. - 2
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Ingår i: Diabetes och Metabola Syndromet. - 9789144133621 ; , s. 115-119
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Bokkapitel (refereegranskat)
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| 2. |
- Li, Sherly X, et al.
(författare)
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Interplay between genetic predisposition, macronutrient intake and type 2 diabetes incidence: analysis within EPIC-InterAct across eight European countries.
- 2018
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Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 1432-0428 .- 0012-186X. ; 61:6, s. 1325-1332
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Tidskriftsartikel (refereegranskat)abstract
- Gene-macronutrient interactions may contribute to the development of type 2 diabetes but research evidence to date is inconclusive. We aimed to increase our understanding of the aetiology of type 2 diabetes by investigating potential interactions between genes and macronutrient intake and their association with the incidence of type 2 diabetes.We investigated the influence of interactions between genetic risk scores (GRSs) for type 2 diabetes, insulin resistance and BMI and macronutrient intake on the development of type 2 diabetes in the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct, a prospective case-cohort study across eight European countries (N=21,900 with 9742 incident type 2 diabetes cases). Macronutrient intake was estimated from diets reported in questionnaires, including proportion of energy derived from total carbohydrate, protein, fat, plant and animal protein, saturated, monounsaturated and polyunsaturated fat and dietary fibre. Using multivariable-adjusted Cox regression, we estimated country-specific interaction results on the multiplicative scale, using random-effects meta-analysis. Secondary analysis used isocaloric macronutrient substitution.No interactions were identified between any of the three GRSs and any macronutrient intake, with low-to-moderate heterogeneity between countries (I2 range 0-51.6%). Results were similar using isocaloric macronutrient substitution analyses and when weighted and unweighted GRSs and individual SNPs were examined.Genetic susceptibility to type 2 diabetes, insulin resistance and BMI did not modify the association between macronutrient intake and incident type 2 diabetes. This suggests that macronutrient intake recommendations to prevent type 2 diabetes do not need to account for differences in genetic predisposition to these three metabolic conditions.
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| 3. |
- Carlsson, S, et al.
(författare)
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Smokeless tobacco (snus) is associated with an increased risk of type 2 diabetes : results from five pooled cohorts
- 2017
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Ingår i: Journal of Internal Medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 281:4, s. 398-406
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Smoking and nicotine exposure increase insulin resistance and the risk of type 2 diabetes. Swedish smokeless tobacco (snus) is high in nicotine, and its use is prevalent in Scandinavian countries, but few studies have investigated snus use in relation to diabetes risk.OBJECTIVE: To explore the association between snus use and risk of type 2 diabetes using pooled data from five cohorts.METHODS: Analyses were based on prospective studies conducted between 1990 and 2013 including 54 531 never-smoking men and 2441 incident cases of type 2 diabetes identified through screening, self-reporting and hospital and prescription registries. Hazard ratios (HRs) and 95% confidence intervals (CIs) were assessed and adjusted for age, body mass index, educational level, alcohol consumption and physical activity.RESULTS: Compared to never users, the HR of type 2 diabetes was 1.15 (95% CI: 1.00-1.32) in current users of snus. In individuals consuming 5-6 boxes per week, the HR was 1.42 (95% CI: 1.07-1.87); in those consuming ≥7 boxes per week, the HR was 1.68 (95% CI: 1.17-2.41). Each additional box of snus consumed per week yielded an HR of 1.08 (95% CI: 1.01-1.16).CONCLUSION: Our findings indicate that high consumption of snus is a risk factor for type 2 diabetes. The risk was similar to that in smokers, implying that smokers will not reduce their risk of type 2 diabetes by changing to snus use. The results also support the notion that nicotine increases the risk of type 2 diabetes.
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| 4. |
- Dybjer, Elin, et al.
(författare)
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Type 1 diabetes, cognitive ability and incidence of cardiovascular disease and death over 60 years of follow-up time in men
- 2022
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Ingår i: Diabetic Medicine. - : Wiley. - 0742-3071 .- 1464-5491. ; 39:8
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Tidskriftsartikel (refereegranskat)abstract
- Aims There are few cohorts of type 1 diabetes that follow individuals over more than half a century in terms of health outcomes. The aim of this study was to examine associations between type 1 diabetes, diagnosed before age 18, and long-term morbidity and mortality, and to investigate whether cognitive ability plays a role in long-term morbidity and mortality risk. Methods In a Swedish cohort, 120 men with type 1 diabetes and 469 without type 1 diabetes were followed between 18 and 77 years of age as regards morbidity and mortality outcomes, and impact of cognitive ability at military conscription for the outcomes. In Cox regression analyses and Kaplan-Meier analyses with log-rank tests, associations between diabetes and cognitive ability respectively, and outcomes (mortality, cardiovascular morbidity and diabetes complications) were investigated. Results Men with type 1 diabetes suffered from dramatically higher mortality (HR 4.62, 95% CI: 3.56-5.60), cardiovascular mortality (HR 5.60, 95% CI: 3.27-9.57), and cardiovascular events (HR 3.97, 95% CI: 2.79-5.64) compared to men without diabetes. Higher cognitive ability at military conscription was associated with lower mortality in men without diabetes, but was not associated with any outcome in men with diabetes. Conclusions In this historical cohort study with 60 years of follow-up time and a less effective treatment of diabetes than today, mortality rates and cardiovascular outcomes were high for men with type 1 diabetes. Morbidity or mortality did not differ between those that had low to normal or high cognitive ability among men with type 1 diabetes.
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| 5. |
- Molvin, John, et al.
(författare)
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Proteomic exploration of common pathophysiological pathways in diabetes and cardiovascular disease
- 2020
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Ingår i: ESC Heart Failure. - : Wiley. - 2055-5822. ; 7:6, s. 4151-4158
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Tidskriftsartikel (refereegranskat)abstract
- Aims The epidemiological association between diabetes and cardiovascular disease is well established, but the pathophysiological link is complex and multifactorial. We investigated seven proteins, previously linked to incident diabetes mellitus, and their association with cardiovascular disease and mortality. Methods and results Plasma samples from 1713 individuals from the Swedish population-based Malmo Preventive Project (mean age 67.4 +/- 6.0 years; 29.1% women) were analysed with a proximity extension assay panel. Seven proteins [scavenger receptor cysteine rich type 1 protein M130 (CD163), fatty acid-binding protein 4 (FABP4), plasminogen activator inhibitor 1 (PAI), insulin-like growth factor-binding protein 2 (IGFB2), cathepsin D (CTSD), galectin-4 (GAL4), and paraoxonase-3 (PON3)] previously shown to be associated with incident diabetes were analysed for associations with all-cause mortality (ACM), cardiovascular mortality (CVM), incident coronary events (CEs), and incident heart failure (HF). After exclusion of prevalent cases of respective outcome, proteins that met Bonferroni-corrected significance were analysed in multivariable Cox regression models. Significant associations were identified between five proteins [GAL4 (hazard ratio; 95% confidence interval: 1.17-1.41), CTSD (1.15-1.37), CD163 (1.09-1.30), IGFBP2 (1.05-1.30), and FABP4 (1.04-1.29)] and ACM and four proteins [GAL4 (1.38-1.56), CTSD (1.14-1.43), CD163 (1.09-1.36), and IGFBP2 (1.03-1.35)] with CVM. Three proteins [GAL4 (1.14-1.57), CTSD (1.12-1.50), and FABP4 (1.05-1.55)] were significantly associated with incident CE and two [GAL4 (1.03-1.54) and CTSD (1.01-1.46)] were associated with incident HF after adjusting for traditional risk factors including N-terminal pro-brain natriuretic peptide. Conclusions In a general Swedish population, four proteins previously shown to be associated with diabetes were associated with ACM and CVM. Three proteins were associated with incident CE. Finally, GAL4 and CTSD displayed novel associations with incident HF and were the only proteins associated with all outcomes.
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| 6. |
- Taimour, Soumia, et al.
(författare)
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Aortic diameter at age 65 in men with newly diagnosed type 2 diabetes
- 2017
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Ingår i: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 51:4, s. 202-206
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. Type 2 diabetes mellitus has been linked to a decreased risk for abdominal aortic aneurysm (aortic diameter 30mm, AAA) development in men. The aim of this study was to evaluate if such an effect is detectable already around the time of diabetes diagnosis. Design. We cross-sectionally compared aortic diameter at ultrasound screening for AAA in 691 men aged 65 years with incipient or newly diagnosed type 2 diabetes (group A) with 18,262 65-year old control men without diabetes (group B). Results. Aortic diameter did not differ between groups (18.8[17.4-20.8] vs. 19.0[17.5-28.7] mm; p=0.43). AAA prevalence was 2.5% in group A and 1.5% in group B (p=.010). In logistic regression taking group differences in body mass index (BMI), smoking, presence of atherosclerotic disease and hypertension into account, the difference in AAA prevalence was no longer significant (p=.15). Among men in group A, C-peptide (r=.093; p=.034), but not HbA1c (r=.060; p=.24) correlated with aortic diameter. Conclusion. Among 65 year old men aortic diameter and AAA prevalence do not differ between those with newly diagnosed type 2 diabetes and those without diabetes. Putative protective effects of type 2 diabetes mellitus against aortic dilatation and AAA development therefore probably occur later after diagnosis of diabetes.
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| 7. |
- Sabale, Ugne, et al.
(författare)
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Weight change patterns and healthcare costs in patients with newly-diagnosed type-2 diabetes in Sweden
- 2017
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Ingår i: Primary Care Diabetes. - : Elsevier BV. - 1751-9918 .- 1878-0210. ; 11:3, s. 217-225
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To describe weight-change pathways in patients with type 2 diabetes (T2D) and associated healthcare costs using repeated BMI measurements and healthcare utilization data.Methods: Patients with newly-diagnosed T2D with body mass index (BMI, kg/m(2)) at diagnosis and subsequent measures at year 1-3 were identified. Based on three-year BMI change, patients were assigned to one of 27 BMI change pathways defined by annual BMI change: BMI NE arrow (>= 1 BMI unit increase), BMI -> (<1 BMI unit change), and BMI SE arrow (>= 1 BMI unit decrease). Mean annual and three-year cumulative healthcare costs were estimated for each pathway by combining Swedish unit costs with resource use from primary care and national patient registers.Results: Cohort consisted of 15,819 patients; 44% women, mean age of 61 years, HbA1c of 6.7% (50 mmol/mol), BMI of 30.6 kg/m(2). Most common BMI pathways (mean costs): BMI ->->-> ((sic)5,311), BMI SE arrow ->->((sic)5,461), and BMI ->->SE arrow((sic)6,281). General trends: BMI)->->-> linked to lowest, BMI NE arrow ->NE arrow linked to highest costs.Conclusion: In patients with newly -diagnosed T2D, weight stability was the most common BMI change pattern over 3 years and associated with lowest healthcare costs. Relationship between weight change and healthcare costs appears complex warranting further investigation.
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| 8. |
- Tremmel, Maximilian, et al.
(författare)
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Characteristics and prognosis of healthy severe obesity (HSO) subjects - The Malmo Preventive Project
- 2018
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Ingår i: Obesity Medicine. - : Elsevier BV. - 2451-8476. ; 11, s. 6-12
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Tidskriftsartikel (refereegranskat)abstract
- Background: The characteristics and prognosis of healthy obesity (HO) still remain unclear. We aimed to examine the characteristics of healthy severe obesity (HSO), defined by a novel approach, with a focus on self-reported physical activity (PA) and a genetic risk score for type 2 diabetes (GRS DM2). Methods: A cross-sectional analysis was carried out in a subsample of severly obese subjects (BMI≥35 kg/m2; n = 809) selected from the population-based Malmo Preventive Project (MPP). Subjects with HSO (n = 57) were defined by having no records of hospitalisation in the Swedish Hospital Discharge Register during a time period of 33.4 ± 3.9 years between baseline (1974–1992) and the end of follow-up (31st of December 2014). They were compared to subjects with unhealthy severe obesity (USO; n = 752), as well as age- and sex-matched non-obese controls (n = 1618). Results: Subjects with HSO had a significantly lower GRS DM2 (HSO 40.4 ± 3.7 vs. USO 41.8 ± 3.8, p = 0.007). Compared to subjects with USO, the HSO subjects reported significantly more leisure-time physical activity, PA (p = 0.016). There were no significant differences between HSO and USO subjects in the distribution of fat mass or obesity-associated gene phenotypes (FTO gene; variant rs9939609; p = 0.8). Conclusion: Higher PA and lower GRS DM2 might be protective factors against all-cause hospitalisation in subjects with severe obesity. These findings support the concept of HO being fat but fit. Still, it remains unclear whether higher PA is causally related to HSO, and which role environmental factors such as PA play in the interaction with genetic factors such as GRS DM2.
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| 9. |
- Imamura, Fumiaki, et al.
(författare)
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Estimated Substitution of Tea or Coffee for Sugar-Sweetened Beverages Was Associated with Lower Type 2 Diabetes Incidence in Case-Cohort Analysis across 8 European Countries in the EPIC-InterAct Study
- 2019
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Ingår i: Journal of Nutrition. - : Elsevier BV. - 0022-3166 .- 1541-6100. ; 149:11, s. 1985-1993
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Beverage consumption is a modifiable risk factor for type 2 diabetes (T2D), but there is insufficient evidence to inform the suitability of substituting 1 type of beverage for another. Objective: The aim of this study was to estimate the risk of T2D when consumption of sugar-sweetened beverages (SSBs) was replaced with consumption of fruit juice, milk, coffee, or tea. Methods: In the European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study of 8 European countries (n = 27,662, with 12,333 cases of incident T2D, 1992-2007), beverage consumption was estimated at baseline by dietary questionnaires. Using Prentice-weighted Cox regression adjusting for other beverages and potential confounders, we estimated associations of substituting 1 type of beverage for another on incident T2D. Results: Mean ± SD of estimated consumption of SSB was 55 ± 105 g/d. Means ± SDs for the other beverages were as follows: fruit juice, 59 ± 101 g/d; milk, 209 ± 203 g/d; coffee, 381 ± 372 g/d; and tea, 152 ± 282 g/d. Substituting coffee for SSBs by 250 g/d was associated with a 21% lower incidence of T2D (95% CI: 12%, 29%). The rate difference was-12.0 (95% CI:-20.0,-5.0) per 10,000 person-years among adults consuming SSBs ≥250 g/d (absolute rate = 48.3/10,000). Substituting tea for SSBs was estimated to lower T2D incidence by 22% (95% CI: 15%, 28%) or-11.0 (95% CI:-20.0,-2.6) per 10,000 person-years, whereas substituting fruit juice or milk was estimated not to alter T2D risk significantly. Conclusions: These findings indicate a potential benefit of substituting coffee or tea for SSBs for the primary prevention of T2D and may help formulate public health recommendations on beverage consumption in different populations.
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| 10. |
- Nilsson, Peter M, et al.
(författare)
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New Antidiabetic Agents for the Treatment of Heart Failure in Hypertensive Patients
- 2024. - 2
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Ingår i: Hypertension and Heart Failure : Epidemiology, Mechanisms and Treatment - Epidemiology, Mechanisms and Treatment. - 2366-4614 .- 2366-4606. - 9783031393143 - 9783031393150 ; , s. 79-371
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Bokkapitel (refereegranskat)abstract
- The development of newer glucose-lowering drugs for the treatment of type 2 diabetes in recent years, such as the SGLT-2 inhibitors and GLP-1 receptor agonists/analogues with well-documented clinical benefits from large trials, has influenced international guidelines. These drugs are able to reduce both macro- and microvascular events in patients with type 2 diabetes and to prevent worsening of diabetic nephropathy. One important aspect of these new drugs is also the ability to prevent or treat heart failure (HF) through improved cardiac metabolism, but also by lowering of blood pressure and improvement of central hemodynamics. In this review, the evidence for such effects on HF is discussed for each drug class separately and in combination. In the future there may come new opportunities for fixed drug combinations (FDC) to improve cost-effectiveness and compliance of diabetes treatment when antihypertensive, lipid-lowering, and glucose-lowering drugs are combined. As control of hypertension is of great importance for HF prevention in patients with diabetes in general, the combination of traditional antihypertensive drugs (i.e., blockers of the renin-angiotensin system) with newer glucose-lowering drugs that may also lower blood pressure could prove to be a successful and a very useful combination. Thus, further studies are warranted.
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