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- Nilsson, Peter, et al.
(författare)
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Smoking is associated with increased HbA1c values and microalbuminuria in patients with diabetes--data from the National Diabetes Register in Sweden
- 2004
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Ingår i: Diabetes Metab. - 1262-3636 .- 1878-1780. ; 30:3, s. 261-8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim was to examine trends in the proportion of smoking in diabetes patients, and to study associations between smoking, glycaemic control, and microalbuminuria. METHODS: Smoking habits were reported to the Swedish National Diabetes Register (NDR), with data from hospitals and primary health care. Patient characteristics included were age, gender, type of treatment, diabetes duration, HbA1c, BMI, blood pressure, antihypertensive and lipid-lowering drugs, and microalbuminuria. RESULTS: The proportion of smokers in type 1 diabetes was 12-15% during 1996-2001, it was high in females<30 years (12-16%), and was higher in the age group 30-59 years (13-17%) than in older (6-9%) patients. The corresponding proportion of smoking in type 2 diabetes was 10-12%, higher in those less than 60 years of age (17-22%) than in older (7-9%) patients. Smoking type 1 and type 2 patients in 2001 had higher mean HbA1c but lower mean BMI values than non-smokers. Smokers also had higher frequencies of microalbuminuria, in both type 1 (18 vs 14%) and type 2 (20% vs 13%) diabetes. Multiple logistic regression analyses disclosed that smoking was independently associated with elevated HbA1c levels (p<0.001) and microalbuminuria (p<0.001), but negatively with BMI (p<0.001), in both type 1 and type 2 diabetes. CONCLUSIONS: Smoking in patients with diabetes was widespread, especially in young female type 1, and in middle-aged type 1 and type 2 diabetes patients, and should be the target for smoking cessation campaigns. Smoking was associated with both poor glycaemic control and microalbuminuria, independently of other study characteristics.
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- Olsson, PO, et al.
(författare)
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Combination-therapy with bedtime NPH insulin and sulphonylureas gives similar glycaemic control but lower weight gain than insulin twice daily in patients with type 2 diabetes
- 2002
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Ingår i: Diabetes & Metabolism. - : Elsevier Masson. - 1262-3636 .- 1878-1780. ; 28:4 Part 1, s. 272-277
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Tidskriftsartikel (refereegranskat)abstract
- Background: To study the effect on body weight and glycaemic control of two insulin treatment regimens in patients with Type 2 diabetes and moderate failure to oral hypoglycaemic agents. Methods: Sixteen patients treated with oral hypoglycaemic agents (6 men and 10 women) were included in this open-label, randomized, parallel group study. Their age was 62 ▒ 2 (mean ▒ SEM) years (range 44-79 years), body weight 71.3 ▒ 2.9 kg, body mass index (BMI) 24.6 ▒ 0.8 kg/m2. The patients were switched to insulin treatment with bedtime NPH insulin combined with daytime sulphonylurea (combination group) or twice daily injections of a premixed combination of regular human and NPH insulin (insulin twice daily group) with measurements as given below before and after 12 and 24 weeks of treatment. Results: HbA1c was lowered from 8.3 ▒ 0.3% to 7.0 ▒ 0.2% in the insulin twice daily group (p < 0.05) and from 8.3 ▒ 0.3% to 6.8 ▒ 0.5% in the combination group (p < 0.03, ns between treatment groups). Body weight increased from 71.7 ▒ 4.0 kg to 77.6 ▒ 4.4 kg in the insulin twice daily group (p < 0.001) and from 70.8 ▒ 4.6 kg to 72.7 ▒ 5.1 kg in the combination group (ns, p < 0.02 between groups). The dose of insulin at 24 weeks in the insulin twice daily group was 45.8 ▒ 4.2 U and 29.4 ▒ 5.4 U in the combination group (p = 0.03). Combination treatment reduced fasting and stimulated C-peptide levels. Conclusions: Both treatments improved glycaemic control to the same extent but the combination of bedtime NPH insulin and daytime sulphonylurea gave a very small increase of body weight over a 6 months period. We conclude that combination therapy is an attractive alternative when starting insulin treatment in patients with Type 2 diabetes as this is a critical period for weight gain in such patients.
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