| 1. |
- Lindehammer, Sabina, et al.
(författare)
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Temporal trends of HLA genotype frequencies of type 1 diabetes patients in Sweden from 1986 to 2005 suggest altered risk
- 2008
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Ingår i: Acta Diabetologica. - : Springer Science and Business Media LLC. - 0940-5429 .- 1432-5233. ; 45:4, s. 231-5
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to compare the frequency of human leukocyte antigen (HLA) genotypes in 1-18-year-old patients with type 1 diabetes newly diagnosed in 1986-1987 (n = 430), 1996-2000 (n = 342) and in 2003-2005 (n = 171). We tested the hypothesis that the HLA DQ genotype distribution changes over time. Swedish type 1 diabetes patients and controls were typed for HLA using polymerase chain reaction amplification and allele specific probes for DQ A1* and B1* alleles. The most common type 1 diabetes HLA DQA1*-B1*genotype 0501-0201/0301-0302 was 36% (153/430) in 1986-1987 and 37% (127/342) in 1996-2000, but decreased to 19% (33/171) in 2003-2005 (P \ 0.0001). The 0501-0201/0501-0201 genotype increased from 1% in 1986-1987 to 7% in 1996-2000 (P = 0.0047) and to 5% in 2003-2005 (P > 0.05). This study in 1-18-year-old Swedish type 1 diabetes patients supports the notion that there is a temporal change in HLA risk.
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| 2. |
- Tiberg, Irén, et al.
(författare)
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Children diagnosed with type 1 diabetes: a randomized controlled trial comparing hospital versus home-based care.
- 2012
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Ingår i: Acta paediatrica. - : Wiley. - 1651-2227 .- 0803-5253. ; 101:10, s. 1069-1073
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To compare two different regimens for children diagnosed with type 1 diabetes: hospital-based care or hospital-based home care (HBHC), referring to specialist care in a home-based setting. Method: The trial took place in Sweden with a randomized controlled design and included 60 children, aged 3-15 years. After 2-3 days with hospital-based care, children were randomized to either continued hospital-based care or to HBHC for 6 days. The primary outcome was the child's metabolic control after 2 years. Secondary outcomes were set to evaluate the family and child situation as well as the healthcare services. This article presents data 6 months after diagnosis. Results: Results showed equivalence between groups in terms of metabolic control, insulin dose, parents' employment and working hours as well as parents' and significant others' absence from work related to the child's diabetes. Parents in the HBHC were more satisfied with the received health care and showed less subsequent healthcare resource use. The level of risk for the family's psychosocial distress assessed at diagnosis was associated with the subsequent use of resources, but not with metabolic control. Conclusion: HBHC was found to be an equally safe and effective way of providing care as hospital-based care at the onset of type 1 diabetes for children who are medically stable.
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| 3. |
- Tiberg, Irén, et al.
(författare)
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Metabolic control, healthcare satisfaction and costs 1 month after diagnosis of type 1 diabetes: a randomised controlled trial of hospital-based care vs. hospital-based home care.
- 2012
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Ingår i: Pediatric Diabetes. - : Hindawi Limited. - 1399-543X. ; 13:8, s. 625-631
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Tidskriftsartikel (refereegranskat)abstract
- Procedures for the initial management of children newly diagnosed with diabetes vary greatly worldwide and the evidence available is insufficient for conclusively determining the best process regarding hospital-based or home-based care. The aim of the study was to compare two different regimens for children with newly diagnosed type 1 diabetes; hospital-based care and hospital-based home care (HBHC), defined as specialist care in a home-based setting. A randomised controlled trial, including 60 children, took place at a university hospital in Sweden during the period of March 2008 to September 2011. After 2-3 d with hospital-based care, children from 3 to 15 yr of age were randomised to either continued hospital-based care for a total of 1-2 wk or to HBHC. This article presents results 1 month after diagnosis. No differences were shown in the daily mean glucose level or in its variability when the children received care but, after discharge, children who received HBHC showed lower mean plasma glucose values and lower variability compared to children who received hospital-based care. Children in HBHC had fewer episodes of hypoglycaemia during the first month after diagnosis. In the HBHC group, parents were more satisfied with the healthcare received and healthcare costs for the first month were 30% lower as compared to hospital-based care. The results 1 month after diagnosis support the HBHC programme as being a safe and cost-effective way of providing care. A follow-up will continue for 2 yr to evaluate which process was best for the majority of families over time.
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| 4. |
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| 5. |
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| 6. |
- Ahlgren, Serina, et al.
(författare)
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Climate and biodiversity impact of beef and lamb production – A case study in Sweden
- 2024
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Ingår i: Agricultural Systems. - : Elsevier Ltd. - 1873-2267 .- 0308-521X. ; 219
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Tidskriftsartikel (refereegranskat)abstract
- CONTEXT: The climate impact of meat production is a hotly debated topic. What is less often highlighted is that grazing ruminants can have positive impacts on biodiversity. OBJECTIVE: The aim of this study was to use a life cycle perspective to assess both the climate and biodiversity impact of different beef and lamb production systems in Sweden. METHODS: Applying a life cycle perspective, a quantitative method to assess biodiversity was used, with a scoring system based on land use. For the climate impact calculations, the ClimAg biophysical systems model was used, including emissions from drained organic soils and carbon sequestration in mineral soils. The functional unit was 1 kg carcass weight. RESULTS AND CONCLUSIONS: The results indicated large differences in biodiversity and climate impact between the production systems studied. Dairy bulls had relative low emissions of greenhouse gases, but also a low biodiversity score (a high score indicates higher level of biodiversity). Beef breed steers and heifers had higher emissions of greenhouse gases but a higher biodiversity score, suggesting a trade-off between climate and biodiversity impact. Also for lamb meat, greenhouse gas emissions vary among production systems. A system with winter born lambs slaughtered in spring, closely followed by spring born lambs slaughtered in autumn, had the lowest emissions, while spring born lambs slaughtered in winter had the highest emissions. Winter lambs on the other hand, had a relatively high biodiversity score, due to a long rearing period and an extensive land use with a high proportion of semi-natural grasslands. Climate impact was in all systems related to methane from enteric fermentation, emissions from manure storage, and emissions from organic soils. With the assumptions made in this study, soil carbon sequestration is suggested to reduce the climate impact by 5–7% of the total emissions. Biodiversity impact was in all systems positively related to the amount of grazing in permanent grasslands, in particular semi-natural grasslands. Because semi-natural grasslands are among the most species rich terrestrial ecosystems in Europe, a large surface area grazed resulted in high biodiversity scores in the present model. SIGNIFICANCE: This study used a novel approach for biodiversity assessment, where the positive contribution of semi-natural grasslands to biodiversity was quantified and put in relation to the modelled climate impact.
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| 7. |
- Ahlgren, Serina, et al.
(författare)
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Miljöpåverkan av svensk nöt- och lammköttsproduktion
- 2022
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Syftet med denna studie har varit att beräkna miljöpåverkan från olika svenska uppfödningsmodeller för nöt- och lammkött i produktionsområdena Götalands norra slättbygder, Götalands skogsbygder, Nedre Norrland samt del av Götalands mellanbygd (Gotland). Inom nötköttsproduktion har mjölkrastjur, mjölkrasstut, köttrastjur, köttrasstut och köttraskviga studerats. För lammkött har vårlamm, höstlamm och vinterlamm undersökts. Miljöpåverkanskategorier som ingått i studien är klimatpåverkan, markanvändning, kväveutsläpp samt påverkan på biologisk mångfald.
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| 8. |
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| 9. |
- Ahlqvist, Emma, et al.
(författare)
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Novel subgroups of adult-onset diabetes and their association with outcomes : a data-driven cluster analysis of six variables
- 2018
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Ingår i: The Lancet Diabetes and Endocrinology. - 2213-8587 .- 2213-8595. ; 6:5, s. 361-369
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundDiabetes is presently classified into two main forms, type 1 and type 2 diabetes, but type 2 diabetes in particular is highly heterogeneous. A refined classification could provide a powerful tool to individualise treatment regimens and identify individuals with increased risk of complications at diagnosis.MethodsWe did data-driven cluster analysis (k-means and hierarchical clustering) in patients with newly diagnosed diabetes (n=8980) from the Swedish All New Diabetics in Scania cohort. Clusters were based on six variables (glutamate decarboxylase antibodies, age at diagnosis, BMI, HbA1c, and homoeostatic model assessment 2 estimates of β-cell function and insulin resistance), and were related to prospective data from patient records on development of complications and prescription of medication. Replication was done in three independent cohorts: the Scania Diabetes Registry (n=1466), All New Diabetics in Uppsala (n=844), and Diabetes Registry Vaasa (n=3485). Cox regression and logistic regression were used to compare time to medication, time to reaching the treatment goal, and risk of diabetic complications and genetic associations.FindingsWe identified five replicable clusters of patients with diabetes, which had significantly different patient characteristics and risk of diabetic complications. In particular, individuals in cluster 3 (most resistant to insulin) had significantly higher risk of diabetic kidney disease than individuals in clusters 4 and 5, but had been prescribed similar diabetes treatment. Cluster 2 (insulin deficient) had the highest risk of retinopathy. In support of the clustering, genetic associations in the clusters differed from those seen in traditional type 2 diabetes.InterpretationWe stratified patients into five subgroups with differing disease progression and risk of diabetic complications. This new substratification might eventually help to tailor and target early treatment to patients who would benefit most, thereby representing a first step towards precision medicine in diabetes.
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| 10. |
- Andersson, Cecilia K, et al.
(författare)
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Glucose tolerance and beta-cell function in islet autoantibody-positive children recruited to a secondary prevention study.
- 2013
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Ingår i: Pediatric Diabetes. - : Hindawi Limited. - 1399-543X .- 1399-5448. ; 14:5, s. 341-349
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Children with type 1 diabetes (T1D) risk and islet autoantibodies are recruited to a secondary prevention study. The aims were to determine metabolic control in relation to human leukocyte antigen (HLA) genetic risk and islet autoantibodies in prepubertal children. METHODS: In 47 healthy children with GADA and at least one additional islet autoantibody, intravenous glucose tolerance test (IvGTT) and oral glucose tolerance test (OGTT) were performed 8-65 d apart. Hemoglobin A1c, plasma glucose as well as serum insulin and C-peptide were determined at fasting and during IvGTT and OGTT. RESULTS: All children aged median 5.1 (4.0-9.2) yr had autoantibodies to two to six of the beta-cell antigens GAD65, insulin, IA-2, and the three amino acid position 325 variants of the ZnT8 transporter. In total, 20/47 children showed impaired glucose metabolism. Decreased (≤30 μU/mL insulin) first-phase insulin response (FPIR) was found in 14/20 children while 11/20 had impaired glucose tolerance in the OGTT. Five children had both impaired glucose tolerance and FPIR ≤30 μU/mL insulin. Number and levels of autoantibodies were not associated with glucose metabolism, except for an increased frequency (p = 0.03) and level (p = 0.01) of ZnT8QA in children with impaired glucose metabolism. Among the children with impaired glucose metabolism, 13/20 had HLA-DQ2/8, compared to 9/27 of the children with normal glucose metabolism (p = 0.03). CONCLUSION: Secondary prevention studies in children with islet autoantibodies are complicated by variability in baseline glucose metabolism. Evaluation of metabolic control with both IvGTT and OGTT is critical and should be taken into account before randomization. All currently available autoantibody tests should be analyzed, including ZnT8QA.
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