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| 2. |
- Agardh, Carl-David, et al.
(författare)
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Diabetic control in community care. The use of clinical evaluation and hemoglobin A1
- 1985
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 3:1, s. 15-18
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Tidskriftsartikel (refereegranskat)abstract
- Diabetic control was evaluated in 50 consecutive patients attending a community care centre, either by clinical criteria or by determination of glycosylated hemoglobin (HbA1). Two methods used for the determination of HbA1 were found to give similar results, namely ion exchange chromatography and agar gel electrophoresis. On a group basis, good correlation was observed between HbA1 samples analysed prior to and following the elimination of the labile HbA1 fraction. When comparing three treatment modes (diet alone, hypoglycemic agents or insulin), no significant differences in HbA1 levels were noted. Patients considered to have satisfactory and poor control had significantly higher HbA1 levels than those considered to have good control, while no differences were seen between those considered to have satisfactory or poor control. It is concluded that the methods described for the determination of HbA1 yield similar results. Clinical evaluation of diabetic control is reliable in patients classified to have good or poor control. However, in many patients who are considered to have satisfactory control, regular determinations of HbA1 provide valuable additional information.
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| 3. |
- Agardh, Carl-David, et al.
(författare)
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Improvement of peripheral nerve function after institution of insulin treatment in diabetes mellitus. A case-control study
- 1983
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Ingår i: Acta Medica Scandinavica. - 0001-6101. ; 213:4, s. 283-287
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Tidskriftsartikel (refereegranskat)abstract
- The influence of improved diabetic control on peripheral nerve function was studied before and 3-4 months after institution of insulin treatment in 22 diabetics unsatisfactorily controlled by oral hypoglycemic agents. After institution of insulin treatment, diabetic control was improved as demonstrated by decreasing levels of HbA1. There was an overall tendency towards improvement of motor and sensory conduction velocities, however significant only in the upper extremities. There was a tendency towards improved temperature sensitivity in the legs, while no changes occurred in the hands and face. The sensation for vibration did not change. It is concluded that improved diabetic control, even in elderly patients with long-standing diabetes, is followed by neurophysiological signs of improved peripheral nerve function.
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| 4. |
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| 5. |
- Asp, N G, et al.
(författare)
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Dietary fibre in type II diabetes
- 1982
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Ingår i: Acta medica Scandinavica. Supplementum. - : Wiley. - 0365-463X .- 0001-6101. ; 210:S656, s. 47-50
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Tidskriftsartikel (refereegranskat)abstract
- Recent studies have indicated that diets rich in digestible carbohydrates and dietary fibre might be beneficial in the regulation of type II non insulin dependent diabetes (NIDD). Addition of the gel forming type of dietary fibre such as pectin and guar gum to meals or glucose solutions reduces post-prandial glucose and insulin response. Addition of cereal fibres in the form of bran seems to have long term beneficial effect improving glucose tolerance. Little is known, however, concerning effects of dietary fibre naturally occurring in food on postprandial glucose and hormone response. In the present study we prepared two breakfast meals which were similar regarding digestible carbohydrates but differed in their dietary fibre content. One of the meals, including whole grain bread and whole apples, contained 8.4 g of dietary fibre, and the other one, containing white bread and apple juice, 3.1 g. When given to eight NIDD, the fibre rich breakfast gave significantly lower blood glucose increment during the three hours following ingestion. The results indicate that foods rich in dietary fibre might be useful in the regulation of type II diabetes.
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| 6. |
- Li, Cairu, et al.
(författare)
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Effects of norethisterone acetate addition to estradiol in long term HRT
- 2000
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Ingår i: Maturitas. - 1873-4111. ; 36:2, s. 139-152
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to evaluate the efficacy and tolerability of hormone replacement therapy (HRT) among postmenopausal women living in the Lund area of Southern Sweden and to analyze treatment effects in different types or routes of HRT administration, as well as to compare with unopposed estrogen therapy. METHOD: in an ongoing, large population-based, prospective cohort study, this interim analysis included 3900 women. Of them, 693 postmenopausal women were eligible in the present analyses as they continued to use one of the four commercial HRT products for at least 2-3 years, i.e. continuous oral estradiol (E(2)) 2 mg+norethisterone acetate (NETA) 1 mg (CON-O), sequential oral estradiol 2 mg + norethisterone acetate 1 mg (CYC-O), sequential transdermal estradiol 50 microg + norethisterone acetate 250 microg (CYC-TRANS) and estradiol monotherapy. These women completed one generic questionnaire and one specific 'hormonal' questionnaire, as well as a personal interview pertaining to socio-demographics, detailed status of HRT use, and therapeutic efficacy and untoward side-effects by HRT. RESULTS: comparing the three combined E(2)+NETA groups with E(2) monotherapy, the beneficial effects on sexual desire and emotional well-being were significantly less in the combined groups than in E(2) monotherapy group. There was no significant difference regarding the negative side-effects between the groups. No significant difference was found between CON-O and CYC-O groups either in positive effects or in negative side-effects. A higher prevalence of positive effects was found in CYC-TRANS group than that in CYC-O group, especially in amelioration of sleep and urinary symptoms. Higher odd ratios of negative effects by HRT, such as irregular bleeds, weight gain, food craving and skin disorders were also found in CYC-TRANS group. CONCLUSION: in long-term HRT administration, the addition of a progestogen in HRT could compromise the beneficial effects of estradiol, particularly, the effects on women's emotional well being and psychosexual functioning. Administration of NETA continuously and sequentially had similar therapeutic efficacy and tolerability. More marked positive effects, such as improving of sleep and urinary symptoms, as well as nuisance side-effects, i.e. irregular bleeds, weight gain, food craving and skin disorders were encountered by the women using sequential transdermal regimen
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| 7. |
- Lidfeldt, Jonas, et al.
(författare)
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A screening procedure detecting high-yield candidates for OGTT. The Women's Health in the Lund Area (WHILA) study: a population based study of middle-aged Swedish women
- 2001
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Ingår i: European Journal of Epidemiology. - 1573-7284. ; 17:10, s. 943-951
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Tidskriftsartikel (refereegranskat)abstract
- The objective was to evaluate a screening procedure for detecting high-yield candidates for an OGTT, in a population of middle-aged Swedish women. A two-step screening procedure was performed in 6917 subjects. Women with a positive screening outcome, i.e. increased non-fasting capillary blood glucose, serum triglycerides, BMI, WHR, blood pressure or a family history of diabetes, pharmacological treatment of hypertension or hyperlipidaemia at the primary screening underwent a 75-g OGTT. A control group of women with negative screening outcome (n = 221) also underwent an OGTT. In 2923 women with positive screening outcome, 517 (17.7%) had NFG/IGT (normal fasting venous blood glucose <5.6 mmol/l and 2h-glucose 6.7-9.9 mmol/l), 109 (3.7%) IFG/IGT (fasting 5.6-6.0 and 2h 6.7-9.9 mmol/l) and 223 (7.6%) diabetes (fasting > or = 6.1 or 2h > or = 10.0 mmol/l). These figures were three, five and four times higher, respectively, than in the control group with negative screening outcome (p < 0.001 for all); no differences were found for IFG/NGT (fasting 5.6-6.0 and normal 2h < 6.7 mmol/l) (4.6% vs. 7.2%). For predicting impaired glucose metabolism (IFG/NGT, NFG/IGT, IFG/IGT, diabetes), the screening instrument showed an estimated sensitivity of 70%, specificity of 55%, positive predictive value of 34% and negative predictive value of 85%, based on findings in the control sample. The odds ratio for NFG/IGT increased with the numbers of risk factors from 2.8 to 7.7, for IFG/ IGT from 5.7 to 55.0 and for diabetes from 2.5 to 18.1. High B-glucose, WHR and BMI were the three most important factors associated with an increased risk for NFG/IGT, IFG/IGT and diabetes. In subjects with IFG/NGT, none of the screening variables was associated with an increased risk. In summary, the results show a population screening method focused on features of the metabolic syndrome that discloses high-yield candidates for OGTT. A high prevalence of unknown impaired glucose metabolism was found in middle-aged women with a positive screening profile.
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| 8. |
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| 9. |
- Lidfeldt, Jonas, et al.
(författare)
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Socio-demographic and psychosocial factors are associated with features of the metabolic syndrome. The Women's Health in the Lund Area (WHILA) study.
- 2003
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Ingår i: Diabetes, Obesity and Metabolism. - : Wiley. - 1462-8902. ; 5:2, s. 106-112
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Tidskriftsartikel (refereegranskat)abstract
- Aim:The aim was to analyse any associations between socio-demographic and psychosocial factors and different features of the metabolic syndrome in a geographically well-defined population of middle-aged women. Methods:A population of 10 766 Caucasian women aged 50-59 years was investigated regarding biological and socio-demographic conditions, physical activity, dietary habits, aspects of quality of life, and subjective physical and mental symptoms. The screening instrument was used to discriminate subjects as positive or negative on one or more of a total of eight variables considered to be linked to the metabolic syndrome. The cut-off values for positive screening were non-fasting capillary blood glucose >= 8.0 mmol/l and serum triglycerides >= 2.3 mmo/l, BMI >= 30 kg/m2, WHR >= 0.90, blood pressure >= 160 and/or 95 mmHg, a family history of diabetes, and pharmacological treatment for hypertension or hyperlipidaemia. Results:Altogether 6805 women (63.2%) participated: 3535 with positive and 3270 with negative screening. Multiple logistic regression analyses showed that comprehensive (OR 1.62, 95% CI 1.41-1.87) and upper secondary (1.40, 1.24-1.57) school, low physical quality of life (1.41, 1.23-1.61) and high sum of subjective physical symptoms (1.06, 1.04-1.08) were positively associated with one or more features of the metabolic syndrome, while high leisure-time exercise and healthy diet (0.84, 0.71-0.99), and low (<= 83 g/week) (0.71, 0.63-0.81) and moderate (84-167 g/week) (0.78, 0.65-0.93) alcohol consumption were negatively associated. Conclusions:To identify middle-aged women with cardiovascular risk factors and high risk for diabetes, it is important to consider not only biological, but also socio-demographic and psychosocial conditions.
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| 10. |
- Lidfeldt, Jonas, et al.
(författare)
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The influence of hormonal status and features of the metabolic syndrome on bone density: A population-based study of Swedish women aged 50 to 59 years. The women's health in the Lund area study
- 2002
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Ingår i: Metabolism, Clinical and Experimental. - : Elsevier BV. - 1532-8600. ; 51:2, s. 267-270
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated whether there is an association between bone density and features of the metabolic syndrome in relation to hormonal status. All women aged 50 to 59 years living in a defined geographic area in Sweden were offered a health assessment program including blood glucose, lipid profile, blood pressure, and bone densitometry. Women were divided into 3 groups according to their hormonal status: premenopausal (PM), postmenopausal with hormone replacement therapy (PMT), and postmenopausal without hormone replacement therapy (PMO). Of the 6,886 women investigated, 7% were PM, 41% PMT, and 52% PMO. The overall prevalence of osteopenia and osteoporosis, according to the World Health Organization (WHO) definition, was 42.6% and 6.6%, respectively. T-score in the PM group was higher than in the PMT (P <.05) and PMO groups (P <.001) and higher in the PMT group compared with the PMO group (P <.001). Also, in the total cohort, the bone density was positively associated with body weight, body mass index (BMI), waist-to-hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), serum triglycerides, and blood glucose (P <.001 for all) and negatively associated with serum levels of cholesterol (P <.05) and high-density lipoprotein (HDL) (P <.001). This was most evident among the PMO women, suggesting that the influence of metabolic factors on bone density increases when the levels of hormones decrease. This indicates that hormone replacement therapy maintains treated women in a premenopausal status concerning the metabolic factors.
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