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The Prevalence of P...
The Prevalence of Polyneuropathy in Type 2 Diabetes Subgroups Based on HOMA2 Indices of b-Cell Function and Insulin Sensitivity
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- Kristensen, Frederik Pagh Bredahl (author)
- Aarhus University Hospital
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- Christensen, Diana Hedevang (author)
- Aarhus University Hospital
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- Callaghan, Brian Christopher (author)
- University of Michigan
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- Stidsen, Jacob Volmer (author)
- Odense University Hospital
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- Nielsen, Jens Steen (author)
- University of Southern Denmark,Odense University Hospital
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- Højlund, Kurt (author)
- University of Southern Denmark,Odense University Hospital
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- Beck-Nielsen, Henning (author)
- Odense University Hospital
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- Jensen, Troels Staehelin (author)
- Aarhus University Hospital
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- Andersen, Henning (author)
- Aarhus University Hospital
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- Vestergaard, Peter (author)
- Steno Diabetes Center Copenhagen
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- Jessen, Niels (author)
- Aarhus University Hospital
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- Olsen, Michael Hecht (author)
- University of Southern Denmark,Holbæk Hospital
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- Hansen, Torben (author)
- Novo Nordisk Foundation Centre for Basic Metabolic Research
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- Brøns, Charlotte (author)
- Steno Diabetes Center Copenhagen
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- Vaag, Allan (author)
- Lund University,Lunds universitet,Translationell diabetesforskning,Forskargrupper vid Lunds universitet,Translational Diabetes Research,Lund University Research Groups,Steno Diabetes Center Copenhagen
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- Sørensen, Henrik Toft (author)
- Aarhus University Hospital
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- Thomsen, Reimar Wernich (author)
- Aarhus University Hospital
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(creator_code:org_t)
- 2023
- 2023
- English 10 s.
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In: Diabetes Care. - 0149-5992. ; 46:8, s. 1546-1555
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http://dx.doi.org/10...
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Abstract
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- OBJECTIVE Metabolic syndrome components may cumulatively increase the risk of diabetic polyneuropathy (DPN) in type 2 diabetes mellitus (T2DM) patients, driven by insulin resistance and hyperinsulinemia. We investigated the prevalence of DPN in three T2DM subgroups based on indices of b-cell function and insulin sensitivity. RESEARCH DESIGN AND METHODS We estimated b-cell function (HOMA2-B) and insulin sensitivity (HOMA2-S) in 4,388 Danish patients with newly diagnosed T2DM. Patients were categorized into subgroups of hyperinsulinemic (high HOMA2-B, low HOMA2-S), classical (low HOMA2-B, low HOMA2-S), and insulinopenic (low HOMA2-B, high HOMA2-S) T2DM. After a median follow-up of 3 years, patients filled the Michigan Neuropathy Screening Instrument questionnaire (MNSIq) to identify DPN (score ‡ 4). We used Poisson regression to calculate adjusted prevalence ratios (PRs) for DPN, and spline models to examine the association with HOMA2-B and HOMA2-S. RESULTS A total of 3,397 (77%) patients filled in the MNSIq. The prevalence of DPN was 23% among hyperinsulinemic, 16% among classical, and 14% among insulinopenic pa-tients. After adjusting for demographics, diabetes duration and therapy, lifestyle behaviors, and metabolic syndrome components (waist circumference, triglycer-ides, HDL cholesterol, hypertension, and HbA1c), the PR of DPN was 1.35 (95% CI 1.15–1.57) for the hyperinsulinemic compared with the classical patients. In spline analyses, we observed a linear relation of higher DPN prevalence with increasing HOMA2-B, independent of both metabolic syndrome components and HOMA2-S. CONCLUSIONS Hyperinsulinemia marked by high HOMA2-B is likely an important risk factor for DPN beyond metabolic syndrome components and insulin resistance. This should be considered when developing interventions to prevent DPN.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
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Kristensen, Fred ...
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Christensen, Dia ...
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Callaghan, Brian ...
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Stidsen, Jacob V ...
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Nielsen, Jens St ...
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Højlund, Kurt
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Beck-Nielsen, He ...
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Jensen, Troels S ...
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Andersen, Hennin ...
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Vestergaard, Pet ...
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Jessen, Niels
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Olsen, Michael H ...
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Hansen, Torben
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Brøns, Charlotte
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Vaag, Allan
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Sørensen, Henrik ...
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Thomsen, Reimar ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Endocrinology an ...
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Diabetes Care
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Lund University