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A Longitudinal Stud...
A Longitudinal Study of Diabetes Mellitus : With Special Reference to Incidence and Prevalence, and to Determinants of Macrovascular Complications and Mortality
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- Jansson, Stefan P.O. 1959- (author)
- Uppsala universitet,Allmänmedicin och preventivmedicin
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- Andersson, Dan K.G. Med Dr (thesis advisor)
- Uppsala universitet,Allmänmedicin och preventivmedicin
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- Svärdsudd, Kurt, Prof (thesis advisor)
- Uppsala universitet,Allmänmedicin och preventivmedicin
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- Eliasson, Mats, Prof (opponent)
- Umeå Universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Medicin
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(creator_code:org_t)
- ISBN 9789155488192
- Uppsala : Acta Universitatis Upsaliensis, 2014
- English 132 s.
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Series: Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, 1651-6206 ; 955
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Abstract
Subject headings
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- Objectives. To investigate diabetes prevalence, incidence, mortality trends, the effects of hyperglycaemia and blood pressure, diabetes and hypertension treatment, and the effect of screening detection on total and cardiovascular disease (CVD), myocardial infarction (MI) and stroke incidence.Study population and methods. Between 1972 and 2001 all patients with diabetes, some detected clinically and some by case-finding procedures (screening), were entered in a diabetes register at Laxå Primary Health Care Center in Sweden. The register included information on medical treatment and laboratory data as well as information on mortality and morbidity from National Registers. The register was supplemented with five non-diabetic subjects, matched to each diabetes patients by age, sex, and year of detection.Results. During the study period 776 new diabetes cases was found, 36 type 1 diabetes mellitus and 740 type 2 diabetes mellitus. Age standardised incidence and prevalence rates for type 1 and type 2 diabetes did not increase over time. Diabetic patients had 17% higher mortality rate than non-diabetic persons, 22% in women and 13% in men. The corresponding over-mortality in CVD was 33%, 41% in women and 27% in men. CVD mortality decreased across time in non-diabetic subjects and in diabetic men but not in diabetic women. Results regarding coronary heart disease (CHD) were similar. CVD incidence increased with fasting blood glucose (FBG), body mass index (BMI), mean arterial blood pressure (MABP), and decreased with metformin treatment and sulfonylurea. Myocardial infarction incidence increased with FBG, BMI and MABP, and decreased with metformin treatment. Stroke incidence increased with MABP. There was no difference in prognoses between those detected by screening or clinically.Conclusions. Diabetes prevalence and incidence did not change over time. The over-mortality according to diabetes was moderate. CVD and MI during follow up were negatively affected by hypertension and hyperglycaemia, and positively by pharmacological diabetic treatment. For stroke no pharmacological protective effect was seen. Screening did not improve prognosis.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Allmänmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- General Practice (hsv//eng)
Keyword
- Diabetes mellitus
- clinical epidemiology
- longitudinal study
- prevalence
- incidence
- mortality
- macrovascular complications
- pharmacological diabetes treatment
- hypertension treatment
- screening
- Family Medicine
- Allmänmedicin
Publication and Content Type
- vet (subject category)
- dok (subject category)
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