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151. Does Training and Support of General Practitioners in Intensive Treatment of People with Screen-Detected Diabetes Improve Medication, Morbidity and Mortality in People with Clinically-Diagnosed Diabetes? Investigation of a Spill-Over Effect in a Cluster RCT

Author

Charles, Morten, primary, Skriver, Mette V., additional, Griffin, Simon J., additional, Simmons, Rebecca K., additional, Witte, Daniel R., additional, Dalsgaard, Else-Marie, additional, Lauritzen, Torsten, additional, and Sandbæk, Annelli, additional

Published
2017
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154. Den uundværlige datafangst

Author

Vestergaard, Mogens, Vedsted, Peter, Obel, Carsten, Sandbæk, Annelli, Christensen, Bo, Olesen, Frede, Lauritzen, Torsten, Bro, Flemming, Andersen, John Sahl, Søndergaard, Jens, Halling, Anders, Bentzen, Niels, Mäkelä, Marjukka, Bjerrum, Lars, Olivarius, Niels de Fine, Kragstrup, Jakob, and Reventlow, Susanne

Published
2014

155. Effect of early multifactorial therapy compared with routine care on microvascular outcomes at 5 years in people with screen-detected diabetes:a randomized controlled trial: the ADDITION-Europe Study

Author

Sandbæk, Annelli, Griffin, Simon J, Sharp, Stephen J, Simmons, Rebecca K, Borch-Johnsen, Knut, Rutten, Guy E H M, van den Donk, Maureen, Wareham, Nicholas J, Lauritzen, Torsten, Davies, Melanie J, and Khunti, Kamlesh

Subjects
Adult, Male, Questionnaires, Primary Health Care, Denmark, General Practice, Great Britain, Middle Aged, Diabetes Mellitus, Type 2, Diabetic Neuropathies, Secondary Prevention, Cluster Analysis, Humans, Mass Screening, Female, Diabetic Angiopathies, Aged, Follow-Up Studies, Netherlands
Abstract

OBJECTIVE: To determine the benefit of multifactorial treatment on microvascular complications among people with type 2 diabetes detected by screening.RESEARCH DESIGN AND METHODS: This study was a multicenter cluster randomized controlled trial in primary care with randomization at the practice level. In four centers in Denmark; Cambridge, U.K.; the Netherlands; and Leicester, U.K., 343 general practices participated in the trial. Eligible for follow-up were 2,861 of the 3,057 people with diabetes detected by screening included in the original trial. Biomedical data on nephropathy were collected in 2,710 (94.7%) participants, retinal photos in 2,190 (76.6%), and questionnaire data on peripheral neuropathy in 2,312 (80.9%). The prespecified microvascular end points were analyzed by intention to treat. Results from the four centers were pooled using fixed-effects meta-analysis.RESULTS: Five years after diagnosis, any kind of albuminuria was present in 22.7% of participants in the intensive treatment (IT) group and in 24.4% in the routine care (RC) group (odds ratio 0.87 [95% CI 0.72-1.07]). Retinopathy was present in 10.2% of the IT group and 12.1% of the RC group (0.84 [0.64-1.10]), and severe retinopathy was present in one patient in the IT group and seven in the RC group. Neuropathy was present in 4.9% and 5.9% (0.95 [0.68-1.34]), respectively. Estimated glomerular filtration rate increased between baseline and follow-up in both groups (4.31 and 6.44 mL/min, respectively).CONCLUSIONS: Compared with RC, an intervention to promote target-driven, intensive management of patients with type 2 diabetes detected by screening was not associated with significant reductions in the frequency of microvascular events at 5 years.

Published
2014

157. General practice plays a role in health check screening

Author

Lauritzen, Torsten, Borch-Johnsen, Knut, and Sandbæk, Annelli

Abstract

A Cochrane review has recently challenged the benefit of health checks. Included studies, screening procedures and treatments were however very heterogeneous and did not fulfil present days standards and most studies were done outside primary care. This review concentrates on research from health checks in Danish general practices focusing on early detection and treatment of risk factors for cardiovascular disease and diabetes. The authors recommend Danish general practitioners to offer opportunistic screening and treatment of people with diabetes and people at risk for cardiovascular disease. Future research questions are highlighted.

Published
2014

158. Change in cardiovascular risk factors following early diagnosis of type 2 diabetes:a cohort analysis of a cluster-randomised trial

Author

Black, James A, Sharp, Stephen J, Wareham, Nicholas J, Sandbæk, Annelli, Rutten, Guy E H M, Lauritzen, Torsten, Khunti, Kamlesh, Davies, Melanie J, Borch-Johnsen, Knut, Griffin, Simon J, and Simmons, Rebecca K

Abstract

BACKGROUND: There is little evidence to inform the targeted treatment of individuals found early in the diabetes disease trajectory.AIM: To describe cardiovascular disease (CVD) risk profiles and treatment of individual CVD risk factors by modelled CVD risk at diagnosis; changes in treatment, modelled CVD risk, and CVD risk factors in the 5 years following diagnosis; and how these are patterned by socioeconomic status.DESIGN AND SETTING: Cohort analysis of a cluster-randomised trial (ADDITION-Europe) in general practices in Denmark, England, and the Netherlands.METHOD: A total of 2418 individuals with screen-detected diabetes were divided into quartiles of modelled 10-year CVD risk at diagnosis. Changes in treatment, modelled CVD risk, and CVD risk factors were assessed at 5 years.RESULTS: The largest reductions in risk factors and modelled CVD risk were seen in participants who were in the highest quartile of modelled risk at baseline, suggesting that treatment was offered appropriately. Participants in the lowest quartile of risk at baseline had very similar levels of modelled CVD risk at 5 years and showed the least variation in change in modelled risk. No association was found between socioeconomic status and changes in CVD risk factors, suggesting that treatment was equitable.CONCLUSION: Diabetes management requires setting of individualised attainable targets. This analysis provides a reference point for patients, clinicians, and policymakers when considering goals for changes in risk factors early in the course of the disease that account for the diverse cardiometabolic profile present in individuals who are newly diagnosed with type 2 diabetes.

Published
2014

159. Erratum:Whole-exome sequencing of 2,000 Danish individuals and the role of rare coding variants in type 2 diabetes (The American Journal of Human Genetics (2013) 93 (1072-1086))

Author

Lohmueller, Kirk E., Sparsø, Thomas, Li, Qibin, Andersson, Ehm, Korneliussen, Thorfinn, Albrechtsen, Anders, Banasik, Karina, Grarup, Niels, Hallgrimsdottir, Ingileif, Kiil, Kristoffer, Kilpeläinen, Tuomas O., Krarup, Nikolaj T., Pers, Tune H., Sanchez, Gaston, Hu, Youna, Degiorgio, Michael, Jørgensen, Torben, Sandbæk, Annelli, Lauritzen, Torsten, Brunak, Søren, Kristiansen, Karsten, Li, Yingrui, Hansen, Torben, Wang, Jun, Nielsen, Rasmus, and Pedersen, Oluf

Subjects
Erratum
Published
2014

160. A randomised trial of the effect and cost-effectiveness of early intensive multifactorial therapy on 5-year cardiovascular outcomes in individuals with screen-detected type 2 diabetes: the Anglo–Danish–Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care (ADDITION-Europe) study

Author

Simmons, Rebecca K, primary, Borch-Johnsen, Knut, additional, Lauritzen, Torsten, additional, Rutten, Guy EHM, additional, Sandbæk, Annelli, additional, van den Donk, Maureen, additional, Black, James A, additional, Tao, Libo, additional, Wilson, Edward CF, additional, Davies, Melanie J, additional, Khunti, Kamlesh, additional, Sharp, Stephen J, additional, Wareham, Nicholas J, additional, and Griffin, Simon J, additional

Published
2016
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161. Early detection and treatment of type 2 diabetes reduce cardiovascular morbidity and mortality: A simulation of the results of the Anglo-Danish-Dutch study of intensive treatment in people with screen-detected diabetes in primary care (ADDITION-Europe)

Author

HAG Diabetes, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Circulatory Health, Herman, William H., Ye, Wen, Griffin, Simon J., Simmons, Rebecca K., Davies, Melanie J., Khunti, Kamlesh, Rutten, Guy E. H. M., Sandbaek, Annelli, Lauritzen, Torsten, Borch-Johnsen, Knut, Brown, Morton B., Wareham, Nicholas J., HAG Diabetes, JC onderzoeksprogramma Cardiovasculaire Epidemiologie, Circulatory Health, Herman, William H., Ye, Wen, Griffin, Simon J., Simmons, Rebecca K., Davies, Melanie J., Khunti, Kamlesh, Rutten, Guy E. H. M., Sandbaek, Annelli, Lauritzen, Torsten, Borch-Johnsen, Knut, Brown, Morton B., and Wareham, Nicholas J.

Published
2015

162. Prevalence of sexual desire and satisfaction among patients with screen-detected diabetes and impact of intensive multifactorial treatment:results from the ADDITION-Denmark study

Author

Pedersen, Mette B., Giraldi, Annamaria, Kristensen, Ellids, Lauritzen, Torsten, Sandbæk, Annelli, Charles, Morten, Pedersen, Mette B., Giraldi, Annamaria, Kristensen, Ellids, Lauritzen, Torsten, Sandbæk, Annelli, and Charles, Morten

Abstract

OBJECTIVE: Sexual problems are common in people with diabetes. It is unknown whether early detection of diabetes and subsequent intensive multifactorial treatment (IT) are associated with sexual health. We report the prevalence of low sexual desire and low sexual satisfaction among people with screen-detected diabetes and compare the impact of intensive multifactorial treatment with the impact of routine care (RC) on these measures.DESIGN: A cross-sectional analysis of the ADDITION-Denmark trial cohort six years post-diagnosis.SETTING: 190 general practices around Denmark.SUBJECTS: A total of 968 patients with screen-detected type 2 diabetes.MAIN OUTCOME MEASURES: Low sexual desire and low sexual satisfaction.RESULTS: Mean (standard deviation, SD) age was 64.9 (6.9) years. The prevalence of low sexual desire was 53% (RC) and 54% (IT) among women, and 24% (RC) and 25% (IT) among men. The prevalence of low sexual satisfaction was 23% (RC) and 18% (IT) among women, and 27% (RC) and 37% (IT) among men. Among men, the prevalence of low sexual satisfaction was significantly higher in the IT group than in the RC group, p = 0.01.CONCLUSION: Low sexual desire and low satisfaction are frequent among men and women with screen-detected diabetes, and IT may negatively impact men's sexual satisfaction.

Published
2015

163. Prediction of adolescent and adult adiposity outcomes from early life anthropometrics

Author

Graversen, Lise, Sørensen, Thorkild I A, Gerds, Thomas A, Petersen, Liselotte, Sovio, Ulla, Kaakinen, Marika, Sandbaek, Annelli, Laitinen, Jaana, Taanila, Anja, Pouta, Anneli, Järvelin, Marjo-Riitta, Obel, Carsten, Graversen, Lise, Sørensen, Thorkild I A, Gerds, Thomas A, Petersen, Liselotte, Sovio, Ulla, Kaakinen, Marika, Sandbaek, Annelli, Laitinen, Jaana, Taanila, Anja, Pouta, Anneli, Järvelin, Marjo-Riitta, and Obel, Carsten

Abstract

OBJECTIVES: Maternal body mass index (BMI), birth weight, and preschool BMI may help identify children at high risk of overweight as they are (1) similarly linked to adolescent overweight at different stages of the obesity epidemic, (2) linked to adult obesity and metabolic alterations, and (3) easily obtainable in health examinations in young children. The aim was to develop early childhood prediction models of adolescent overweight, adult overweight, and adult obesity.METHODS: Prediction models at various ages in the Northern Finland Birth Cohort born in 1966 (NFBC1966) were developed. Internal validation was tested using a bootstrap design, and external validation was tested for the model predicting adolescent overweight using the Northern Finland Birth Cohort born in 1986 (NFBC1986).RESULTS: A prediction model developed in the NFBC1966 to predict adolescent overweight, applied to the NFBC1986, and aimed at labelling 10% as "at risk" on the basis of anthropometric information collected until 5 years of age showed that half of those at risk in fact did become overweight. This group constituted one-third of all who became overweight.CONCLUSIONS: Our prediction model identified a subgroup of children at very high risk of becoming overweight, which may be valuable in public health settings dealing with obesity prevention.

Published
2015

164. Glucagon-Like Peptide-1 (GLP-1) Response to Oral Glucose is Reduced in Pre-diabetes, Screen-detected Type 2 Diabetes and Obesity, and Influenced by Sex:The ADDITION-PRO Study

Author

Færch, Kristine, Torekov, Signe S, Vistisen, Dorte, Johansen, Nanna B, Witte, Daniel R, Jonsson, Anna, Pedersen, Oluf, Hansen, Torben, Lauritzen, Torsten, Sandbæk, Annelli, Holst, Jens Juul, Jørgensen, Marit E, Færch, Kristine, Torekov, Signe S, Vistisen, Dorte, Johansen, Nanna B, Witte, Daniel R, Jonsson, Anna, Pedersen, Oluf, Hansen, Torben, Lauritzen, Torsten, Sandbæk, Annelli, Holst, Jens Juul, and Jørgensen, Marit E

Abstract

The role of glucose-stimulated release of glucagon-like peptide-1 (GLP-1) in the development of obesity and type 2 diabetes is unclear. We assessed GLP-1 response to oral glucose in a large study population of lean and obese men and women with normal and impaired glucose regulation. Circulating concentrations of glucose, insulin and GLP-1 during an oral glucose tolerance test (OGTT) were analyzed in individuals with normal glucose tolerance (NGT, n=774), pre-diabetes (n=523) or screen-detected type 2 diabetes (n=163) who attended the Danish ADDITION-PRO study (n=1,462). Compared with individuals with NGT, women with pre-diabetes or type 2 diabetes had 25% lower GLP-1 response to an OGTT, and both men and women with pre-diabetes or type 2 diabetes had 16-21% lower 120-min GLP-1 concentrations independent of age and obesity. Obese and overweight individuals had 20% reduced GLP-1 response to oral glucose compared with normal weight individuals independent of glucose tolerance status. Higher GLP-1 responses were associated with better insulin sensitivity and beta cell function, higher age and lower degree of obesity. Our findings indicate that a reduction in GLP-1 response to oral glucose occurs prior to the development of type 2 diabetes and obesity, which can have consequences for early prevention strategies for diabetes.

Published
2015

165. Screening for diabetes: what do the results of the ADDITION trial mean for clinical practice?

Author

Lauritzen, Torsten, Borch-Johnsen, Knut, Davies, Melanie J, Khunti, Kamlesh, Rutten, Guy EHM, Sandbæk, Annelli, Simmons, Rebecca, Donk, Maureen van den, Wareham, Nicholas J, and Griffin, Simon J

Subjects
Type 2 dabetes, Diabetes, Screening, Impaired glucose tolerance, Cardiovascular risk, Impaired fasting glucose
Abstract

Artiklen opsummerer de nuværende resultater fra ADDITION studiet. Forfatterne konkluderer at ADDITION studiet har skabt yderligere evidens til støtte for tidlig opsporing og behandling af patienter med uerkendt diabetes. Frem for at fokusere på populationsbaseret screening opfordre forfatterne praktiserende læger til at fokusere på tidlig opsporing fx ved opportunistisk screening. For hver diabetiker, som findes ved screening, vil man finde ca. 6 med høj risiko for hjertekarsygdom (SCORE≥5) uden at vedkomne har diabetes. Lægerne opfordres til at behandle såvel de fundne diabetikere som de personer, som findes med høj risiko for diabetes eller høj risiko for hjertekarsygdom uden diabetes i henhold til gældende vejledninger, det vil sige livsstilsrådgivning og rådgivning om forebyggende farmakologisk behandling med blodtrykssænkende, kolesterolsænkende og blodsukkersænkende medicin. Resultaterne understøtter således DSAM’s nuværende screenings- og behandlingsalgoritmer.

Published
2013

167. Correction to: Soluble CD163, adiponectin, C-reactive protein and progression of dysglycaemia in individuals at high risk of type 2 diabetes mellitus: the ADDITION-PRO cohort.

Author

Deichgræber, Pia, Witte, Daniel R., Møller, Holger J., Skriver, Mette V., Richelsen, Bjørn, Jørgensen, Marit E., Johansen, Nanna B., and Sandbæk, Annelli

Abstract

The authors have discovered a coding error in the statistical analysis syntax file used for the mixed-effect model analyses in this paper. The error has led to differences (first decimal) in the estimates for the main results. [ABSTRACT FROM AUTHOR]

Published
2018
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168. Supporting the health and self-care among vulnerable citizens with diabetes: lessons from a person-centred model of integrated care in Aarhus, Denmark.

Author

Due Jensen, Sissel, Rahbæk, Marie Ørts, Andersen, Anette, Prætorius, Thim, Østerby, Sussie, and Sandbæk, Annelli

Subjects
SOCIAL support, DIABETES, PATIENT-centered care, CONFERENCES & conventions, AT-risk people, INTERPROFESSIONAL relations, HEALTH promotion, HEALTH self-care
Abstract

Introduction: People of lower socioeconomic status (SES) are at higher risk of developing diabetes complications because they face more difficulties in taking care of their disease. People with another ethnic background than Danish are at particular high risk. The Western part of Aarhus, Denmark, is a community with a high proportion of vulnerable citizens, primarily people of low SES and/or another ethnic background, living with type 2 diabetes where it is urgent to improve diabetes management. During a two-year project, a diabetes-nurse employed in the municipality health center offered a tailored, person-centred intervention in collaboration with general practitioners. Methods: Using mixed methods, the aim was to (a) study how the integrated care model and diabetes-nurse work to support vulnerable citizens and (b) measure the effect of tailoring interventions to the individual. Quantitatively, the study uses data on patient outcomes, e.g. HbA1c levels, process measures, e.g., participation in program activities, and patient reported outcomes, e.g., SF12 (n=40). Qualitatively, the study uses ethnographic observations, e.g., shadowing health care professionals, and interviews with nurses (n=3), citizens (n=14) and GP's (n=3) to zoom in on experiences and experienced outcome, cross-sectoral cooperation, challenges, opportunities, and sustainability by shadowing the daily work of the diabetes-nurse. Highlights: The diabetes-nurse used three main drivers to support this diverse groups of citizens living with complex social and health related issues. (1) Relational work: build trust to actually start addressing diabetes-related issues. (2) Person-centred: start with the most pressing issues defined by the citizens themselves, thereby often dealing with issues unrelated to diabetes (3) Engaging the local community: take advantage of the community health center being placed within the citizens' neighborhood. Citizens highlight that they value the relationship with the diabetesnurse and that all their complex social and health related issues are managed by one health care professional who proactively guide them through the health care system. Preliminary quantitative results show that the average HbA1c levels decreased by 10 mmol/mol and that the proportion of citizens who experienced good well-being and high quality of life increased from 41% to 74%. Conclusions: Supporting vulnerable citizens with diabetes alongside other complex medical, social and cultural issues is challenging. This project used a model of integrated care where a diabetes nurse used a relational and patient-centered approach to help vulnerable citizens improve their diabetes self-care and clinical outcomes. Implications for applicability/transferability, sustainability, and limitations The project initially struggled with patient recruitment. The project is unable to document longerterm effects. Future studies are needed about the extent to which new habits and care outcomes are maintained. Covid-19 influenced the intervention in terms of citizens' motivation and participation in program activities. [ABSTRACT FROM AUTHOR]

Published
2022
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169. Intersectoral collaboration in type 2 diabetes care revisited. A project on the co-creation of intersectoral diabetes care in a Danish healthcare setting.

Author

Andersen, Anne Bendix, Hald, Kathrine, Frøkjær, Line Falk, Brun, Steffen, and Sandbæk, Annelli

Subjects
MEDICAL quality control, CONFERENCES & conventions, TYPE 2 diabetes, INTERPROFESSIONAL relations, HEALTH care teams
Abstract

Background: Around 10,000 adults who live in the area referred to as 'Midtklyngen' in the Central Denmark Region are diagnosed with type 2 diabetes. 'Midtklyngen' consists of three municipalities served by two out-patient diabetes clinics and 150 general practitioners. The burden of type 2 diabetes varies throughout the life of a patient, and the social inequalities associated with incidence, prevalence and risk of complications are well described. Furthermore, it is evident that cross-sectoral collaboration in connection with type 2 diabetes often causes fragmented care delivery. Thus, it is of great value to develop a model for collaboration across sectors; a model that promotes and supports the individual patient's chances of living a meaningful life, minimising the clinical consequences of type 2 diabetes through high-quality treatment and care. Purpose: The purpose of the present study was to develop a collaboration model, founded on the principle of joint population responsibility across the healthcare disciplines in Denmark, which are all involved in the cross-sectoral treatment of patients suffering from type 2 diabetes. Methods: Setting: The study was conducted in the three municipalities of Silkeborg, Skive and Viborg, often referred to as 'Midtklyngen', in the Central Denmark Region, and was performed in the hospitals, municipal healthcare centres and general practices in these three municipalities. Baseline was 1 January 2020 and the study will be completed by the end of March 2022. Population: All adults living in the municipalities of Silkeborg, Skive and Viborg who were diagnosed with type 2 diabetes. Design: The study was designed as a quality and improvement project. Data sources: Both quantitative population data and qualitative data which were collected through field studies and interviews were applied in the study. Interventions: The quantitative and qualitative data gave rise to four sub-projects. One sub-project was designed as a series of webinars, produced in collaboration with an endocrinologist from the hospital sector and offered to general practice as an educational tool to be used in the care of patients with type 2 diabetes. Two other interventions aimed at developing the collaboration between the GP clinics and the healthcare centres in the municipalities, with particular focus on patient participation and satisfaction, and also at maintaining healthier habits in the long-term secondary prevention of type 2 diabetes. Finally, the last intervention was an interview study where patients with type 2 diabetes were interviewed and asked about their attitudes towards collaboration between general practice, municipalities and hospital. The last intervention functioned as back ground material for the final collaboration model. Outcomes: Based on the four sub-projects, a cross-sectoral collaboration model for type 2 diabetes will be developed in late 2021. Results: The final work on the interventions and the cross-sectoral collaboration model for type 2 diabetes will be presented at the International Conference on Integrated Care, which will take place in Odense on 23-25 May 2022. [ABSTRACT FROM AUTHOR]

Published
2022
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170. Effect of intensive multifactorial treatment compared with routine care on aortic stiffness and central blood pressure among individuals with screen-detected type 2 diabetes:the ADDITION-Denmark study

Author

Johansen, Nanna Borup, Charles, Morten, Vistisen, Dorte, Rasmussen, Signe Sabine Sætre, Wiinberg, Niels, Borch-Johnsen, Knut, Lauritzen, Torsten, Sandbæk, Annelli, and Witte, Daniel Rinse

Abstract

OBJECTIVEDiabetes is associated with increased brachial and central blood pressure and aortic stiffness. We examined the effect of intensive multifactorial treatment in general practice on indices of peripheral and central hemodynamics among patients with screen-detected diabetes.RESEARCH DESIGN AND METHODSAs part of a population-based screening and intervention study in general practice, 1,533 Danes aged 40-69 years were clinically diagnosed with screen-detected diabetes. General practitioners were randomized to provide intensive multifactorial treatment or routine care. After a mean follow-up of 6.2 years, an unselected subsample of 456 patients underwent central hemodynamic assessments by applanation tonometry. Central pressure was derived from the radial pulse wave. Aortic stiffness was assessed as carotid-femoral pulse wave velocity (aPWV). The intervention effect on each index of central hemodynamics was analyzed by mixed-effects models adjusted for heart rate, cluster randomization, age, and sex.RESULTSAt screening, median age was 59.2 years (interquartile range 55.2-64.6); 289 patients (63%) were in the intensive treatment group, and 278 patients (61%) were men. Patients in the intensive treatment group had a 0.51 m/s (95% CI -0.96 to -0.05, P = 0.03) lower aPWV compared with routine care. Respective differences for central augmentation index (-0.84% [-2.54 to 0.86]), pulse pressure (0.28 mmHg [-1.75 to 2.32]), and systolic (-1.42 mmHg [-4.47 to 1.64]) and diastolic (-1.79 mmHg [-3.72 to 0.14]) blood pressure were not statistically significant.CONCLUSIONSIntensive multifactorial treatment of screen-detected diabetes during 6 years in general practice has a significant impact on aortic stiffness, whereas the effects on other hemodynamic measures are smaller and not statistically significant.

Published
2012

171. A Genome-Wide Association Search for Type 2 Diabetes Genes in African Americans

Author

Palmer, Nicholette D, McDonough, Caitrin W, Hicks, Pamela J, Roh, Bong H, Wing, Maria R, An, S Sandy, Hester, Jessica M, Cooke, Jessica N, Bostrom, Meredith A, Rudock, Megan E, Talbert, Matthew E, Lewis, Joshua P, DIAGRAM Consortium, MAGIC Investigators, Ferrara, Assiamira, Lu, Lingyi, Ziegler, Julie T, Sale, Michele M, Divers, Jasmin, Shriner, Daniel, Adeyemo, Adebowale, Rotimi, Charles N, Ng, Maggie CY, Langefeld, Carl D, Freedman, Barry I, Bowden, Donald W, Voight, Benjamin F, Scott, Laura J, Steinthorsdottir, Valgerdur, Morris, Andrew P, Dina, Christian, Welch, Ryan P, Zeggini, Eleftheria, Huth, Cornelia, Aulchenko, Yurii S, Thorleifsson, Gudmar, McCulloch, Laura J, Ferreira, Teresa, Grallert, Harald, Amin, Najaf, Wu, Guanming, Willer, Cristen J, Raychaudhuri, Soumya, McCarroll, Steve A, Langenberg, Claudia, Hofmann, Oliver M, Dupuis, Josée, Qi, Lu, Segrè, Ayellet V, Van Hoek, Mandy, Navarro, Pau, Ardlie, Kristin, Balkau, Beverley, Benediktsson, Rafn, Bennett, Amanda J, Blagieva, Roza, Boerwinkle, Eric, Bonnycastle, Lori L, Boström, Kristina Bengtsson, Bravenboer, Bert, Bumpstead, Suzannah, Burtt, Noël P, Charpentier, Guillaume, Chines, Peter S, Cornelis, Marilyn, Couper, David J, Crawford, Gabe, Doney, Alex SF, Elliott, Katherine S, Elliott, Amanda L, Erdos, Michael R, Fox, Caroline S, Franklin, Christopher S, Ganser, Martha, Gieger, Christian, Grarup, Niels, Green, Todd, Griffin, Simon, Groves, Christopher J, Guiducci, Candace, Hadjadj, Samy, Hassanali, Neelam, Herder, Christian, Isomaa, Bo, Jackson, Anne U, Johnson, Paul RV, Jørgensen, Torben, Kao, Wen HL, Klopp, Norman, Kong, Augustine, Kraft, Peter, Kuusisto, Johanna, Lauritzen, Torsten, Li, Man, Lieverse, Aloysius, Lindgren, Cecilia M, Lyssenko, Valeriya, Marre, Michel, Meitinger, Thomas, Midthjell, Kristian, Morken, Mario A, Narisu, Narisu, Nilsson, Peter, Owen, Katharine R, Payne, Felicity, Perry, John RB, Petersen, Ann-Kristin, Platou, Carl, Proença, Christine, Prokopenko, Inga, Rathmann, Wolfgang, Rayner, N William, Robertson, Neil R, Rocheleau, Ghislain, Roden, Michael, Sampson, Michael J, Saxena, Richa, Shields, Beverley M, Shrader, Peter, Sigurdsson, Gunnar, Sparsø, Thomas, Strassburger, Klaus, Stringham, Heather M, Sun, Qi, Swift, Amy J, Thorand, Barbara, Tichet, Jean, Tuomi, Tiinamaija, Van Dam, Rob M, Van Haeften, Timon W, Van Herpt, Thijs, Van Vliet-Ostaptchouk, Jana V, Walters, G Bragi, Weedon, Michael N, Wijmenga, Cisca, Witteman, Jacqueline, Bergman, Richard N, Cauchi, Stephane, Collins, Francis S, Gloyn, Anna L, Gyllensten, Ulf, Hansen, Torben, Hide, Winston A, Hitman, Graham A, Hofman, Albert, Hunter, David J, Hveem, Kristian, Laakso, Markku, Mohlke, Karen L, Morris, Andrew D, Palmer, Colin NA, Pramstaller, Peter P, Rudan, Igor, Sijbrands, Eric, Stein, Lincoln D, Tuomilehto, Jaakko, Uitterlinden, Andre, Walker, Mark, Wareham, Nicholas J, Watanabe, Richard M, Abecasis, Goncalo R, Boehm, Bernhard O, Campbell, Harry, Daly, Mark J, Hattersley, Andrew T, Hu, Frank B, Meigs, James B, Pankow, James S, Pedersen, Oluf, Wichmann, H-Erich, Barroso, Inês, Florez, Jose C, Frayling, Timothy M, Groop, Leif, Sladek, Rob, Thorsteinsdottir, Unnur, Wilson, James F, Illig, Thomas, Froguel, Philippe, Van Duijn, Cornelia M, Stefansson, Kari, Altshuler, David, Boehnke, Michael, McCarthy, Mark I, Soranzo, Nicole, Wheeler, Eleanor, Glazer, Nicole L, Bouatia-Naji, Nabila, Mägi, Reedik, Randall, Joshua, Johnson, Toby, Elliott, Paul, Rybin, Denis, Henneman, Peter, Dehghan, Abbas, Hottenga, Jouke Jan, Song, Kijoung, Goel, Anuj, Egan, Josephine M, Lajunen, Taina, Doney, Alex, Kanoni, Stavroula, Cavalcanti-Proença, Christine, Kumari, Meena, Timpson, Nicholas J, Zabena, Carina, Ingelsson, Erik, An, Ping, O'Connell, Jeffrey, Luan, Jian'an, Elliott, Amanda, McCarroll, Steven A, Roccasecca, Rosa Maria, Pattou, François, Sethupathy, Praveen, Ariyurek, Yavuz, Barter, Philip, Beilby, John P, Ben-Shlomo, Yoav, Bergmann, Sven, Bochud, Murielle, Bonnefond, Amélie, Borch-Johnsen, Knut, Böttcher, Yvonne, Brunner, Eric, Bumpstead, Suzannah J, Chen, Yii-Der Ida, Chines, Peter, Clarke, Robert, Coin, Lachlan JM, Cooper, Matthew N, Crisponi, Laura, Day, Ian NM, De Geus, Eco JC, Delplanque, Jerome, Fedson, Annette C, Fischer-Rosinsky, Antje, Forouhi, Nita G, Frants, Rune, Franzosi, Maria Grazia, Galan, Pilar, Goodarzi, Mark O, Graessler, Jürgen, Grundy, Scott, Gwilliam, Rhian, Hallmans, Göran, Hammond, Naomi, Han, Xijing, Hartikainen, Anna-Liisa, Hayward, Caroline, Heath, Simon C, Hercberg, Serge, Hicks, Andrew A, Hillman, David R, Hingorani, Aroon D, Hui, Jennie, Hung, Joe, Jula, Antti, Kaakinen, Marika, Kaprio, Jaakko, Kesaniemi, Y Antero, Kivimaki, Mika, Knight, Beatrice, Koskinen, Seppo, Kovacs, Peter, Kyvik, Kirsten Ohm, Lathrop, G Mark, Lawlor, Debbie A, Le Bacquer, Olivier, Lecoeur, Cécile, Li, Yun, Mahley, Robert, Mangino, Massimo, Manning, Alisa K, Martínez-Larrad, María Teresa, McAteer, Jarred B, McPherson, Ruth, Meisinger, Christa, Melzer, David, Meyre, David, Mitchell, Braxton D, Mukherjee, Sutapa, Naitza, Silvia, Neville, Matthew J, Oostra, Ben A, Orrù, Marco, Pakyz, Ruth, Paolisso, Giuseppe, Pattaro, Cristian, Pearson, Daniel, Peden, John F, Pedersen, Nancy L, Perola, Markus, Pfeiffer, Andreas FH, Pichler, Irene, Polasek, Ozren, Posthuma, Danielle, Potter, Simon C, Pouta, Anneli, Province, Michael A, Psaty, Bruce M, Rayner, Nigel W, Rice, Kenneth, Ripatti, Samuli, Rivadeneira, Fernando, Rolandsson, Olov, Sandbaek, Annelli, Sandhu, Manjinder, Sanna, Serena, Sayer, Avan Aihie, Scheet, Paul, Seedorf, Udo, Sharp, Stephen J, Shields, Beverley, Sijbrands, Eric JG, Silveira, Angela, Simpson, Laila, Singleton, Andrew, Smith, Nicholas L, Sovio, Ulla, Swift, Amy, Syddall, Holly, Syvänen, Ann-Christine, Tanaka, Toshiko, Tönjes, Anke, Uitterlinden, André G, Van Dijk, Ko Willems, Varma, Dhiraj, Visvikis-Siest, Sophie, Vitart, Veronique, Vogelzangs, Nicole, Waeber, Gérard, Wagner, Peter J, Walley, Andrew, Ward, Kim L, Watkins, Hugh, Wild, Sarah H, Willemsen, Gonneke, Witteman, Jaqueline CM, Yarnell, John WG, Zelenika, Diana, Zethelius, Björn, Zhai, Guangju, Zhao, Jing Hua, Zillikens, M Carola, Borecki, Ingrid B, Loos, Ruth JF, Meneton, Pierre, Magnusson, Patrik KE, Nathan, David M, Williams, Gordon H, Silander, Kaisa, Salomaa, Veikko, Smith, George Davey, Bornstein, Stefan R, Schwarz, Peter, Spranger, Joachim, Karpe, Fredrik, Shuldiner, Alan R, Cooper, Cyrus, Dedoussis, George V, Serrano-Ríos, Manuel, Lind, Lars, Palmer, Lyle J, Franks, Paul W, Ebrahim, Shah, Marmot, Michael, Kao, WH Linda, Pramstaller, Peter Paul, Wright, Alan F, Stumvoll, Michael, Hamsten, Anders, Buchanan, Thomas A, Valle, Timo T, Rotter, Jerome I, Siscovick, David S, Penninx, Brenda WJH, Boomsma, Dorret I, Deloukas, Panos, Spector, Timothy D, Ferrucci, Luigi, Cao, Antonio, Scuteri, Angelo, Schlessinger, David, Uda, Manuela, Ruokonen, Aimo, Jarvelin, Marjo-Riitta, Waterworth, Dawn M, Vollenweider, Peter, Peltonen, Leena, Mooser, Vincent, Sladek, Robert, Center for Liver, Digestive and Metabolic Diseases (CLDM), Palmer, Nd, Mcdonough, Cw, Hicks, Pj, Roh, Bh, Wing, Mr, An, S, Hester, Jm, Cooke, Jn, Bostrom, Ma, Rudock, Me, Talbert, Me, Lewis, Jp, Diagram, Consortium, Magic, Investigator, Ferrara, A, Lu, L, Ziegler, Jt, Sale, Mm, Divers, J, Shriner, D, Adeyemo, A, Rotimi, Cn, Ng, Mc, Langefeld, Cd, Freedman, Bi, Bowden, Dw, Voight, Bf, Scott, Lj, Steinthorsdottir, V, Morris, Ap, Dina, C, Welch, Rp, Zeggini, E, Huth, C, Aulchenko, Y, Thorleifsson, G, Mcculloch, Lj, Ferreira, T, Grallert, H, Amin, N, Wu, G, Willer, Cj, Raychaudhuri, S, Mccarroll, Sa, Langenberg, C, Hofmann, Om, Dupuis, J, Qi, L, Segrè, Av, van Hoek, M, Navarro, P, Ardlie, K, Balkau, B, Benediktsson, R, Bennett, Aj, Blagieva, R, Boerwinkle, E, Bonnycastle, Ll, Boström, Kb, Bravenboer, B, Bumpstead, S, Burtt, Np, Charpentier, G, Chines, P, Cornelis, M, Couper, Dj, Crawford, G, Doney, A, Elliott, K, Elliott, Al, Erdos, Mr, Fox, C, Franklin, C, Ganser, M, Gieger, C, Grarup, N, Green, T, Griffin, S, Groves, Cj, Guiducci, C, Hadjadj, S, Hassanali, N, Herder, C, Isomaa, B, Jackson, Au, Johnson, Pr, Jørgensen, T, Kao, Wh, Klopp, N, Kong, A, Kraft, P, Kuusisto, J, Lauritzen, T, Li, M, Lieverse, A, Lindgren, Cm, Lyssenko, V, Marre, M, Meitinger, T, Midthjell, K, Morken, Ma, Narisu, N, Nilsson, P, Owen, Kr, Payne, F, Perry, Jr, Petersen, Ak, Platou, C, Proença, C, Prokopenko, I, Rathmann, W, Rayner, Nw, Robertson, Nr, Rocheleau, G, Roden, M, Sampson, Mj, Saxena, R, Shields, Bm, Shrader, P, Sigurdsson, G, Sparsø, T, Strassburger, K, Stringham, Hm, Sun, Q, Swift, Aj, Thorand, B, Tichet, J, Tuomi, T, van Dam, Rm, van Haeften, Tw, van Herpt, T, van Vliet Ostaptchouk, Jv, Walters, Gb, Weedon, Mn, Wijmenga, C, Witteman, J, Bergman, Rn, Cauchi, S, Collins, F, Gloyn, Al, Gyllensten, U, Hansen, T, Hide, Wa, Hitman, Ga, Hofman, A, Hunter, Dj, Hveem, K, Laakso, M, Mohlke, Kl, Morris, Ad, Palmer, Cn, Pramstaller, Pp, Rudan, I, Sijbrands, E, Stein, Ld, Tuomilehto, J, Uitterlinden, A, Walker, M, Wareham, Nj, Watanabe, Rm, Abecasis, Gr, Boehm, Bo, Campbell, H, Daly, Mj, Hattersley, At, Hu, Fb, Meigs, Jb, Pankow, J, Pedersen, O, Wichmann, He, Barroso, I, Florez, Jc, Frayling, Tm, Groop, L, Sladek, R, Thorsteinsdottir, U, Wilson, Jf, Illig, T, Froguel, P, van Duijn, Cm, Stefansson, K, Altshuler, D, Boehnke, M, Mccarthy, Mi, Soranzo, N, Wheeler, E, Glazer, Nl, Bouatia Naji, N, Mägi, R, Randall, J, Johnson, T, Elliott, P, Rybin, D, Henneman, P, Dehghan, A, Hottenga, Jj, Song, K, Goel, A, Egan, Jm, Lajunen, T, Kanoni, S, Cavalcanti Proença, C, Kumari, M, Timpson, Nj, Zabena, C, Ingelsson, E, An, P, O'Connell, J, Luan, J, Elliott, A, Roccasecca, Rm, Pattou, F, Sethupathy, P, Ariyurek, Y, Barter, P, Beilby, Jp, Ben Shlomo, Y, Bergmann, S, Bochud, M, Bonnefond, A, Borch Johnsen, K, Böttcher, Y, Brunner, E, Bumpstead, Sj, Chen, Yd, Clarke, R, Coin, Lj, Cooper, Mn, Crisponi, L, Day, In, de Geus, Ej, Delplanque, J, Fedson, Ac, Fischer Rosinsky, A, Forouhi, Ng, Frants, R, Franzosi, Mg, Galan, P, Goodarzi, Mo, Graessler, J, Grundy, S, Gwilliam, R, Hallmans, G, Hammond, N, Han, X, Hartikainen, Al, Hayward, C, Heath, Sc, Hercberg, S, Hicks, Aa, Hillman, Dr, Hingorani, Ad, Hui, J, Hung, J, Jula, A, Kaakinen, M, Kaprio, J, Kesaniemi, Ya, Kivimaki, M, Knight, B, Koskinen, S, Kovacs, P, Kyvik, Ko, Lathrop, Gm, Lawlor, Da, Le Bacquer, O, Lecoeur, C, Li, Y, Mahley, R, Mangino, M, Manning, Ak, Martínez Larrad, Mt, Mcateer, Jb, Mcpherson, R, Meisinger, C, Melzer, D, Meyre, D, Mitchell, Bd, Mukherjee, S, Naitza, S, Neville, Mj, Oostra, Ba, Orrù, M, Pakyz, R, Paolisso, Giuseppe, Pattaro, C, Pearson, D, Peden, Jf, Pedersen, Nl, Perola, M, Pfeiffer, Af, Pichler, I, Polasek, O, Posthuma, D, Potter, Sc, Pouta, A, Province, Ma, Psaty, Bm, Rice, K, Ripatti, S, Rivadeneira, F, Rolandsson, O, Sandbaek, A, Sandhu, M, Sanna, S, Sayer, Aa, Scheet, P, Seedorf, U, Sharp, Sj, Shields, B, Sijbrands, Ej, Silveira, A, Simpson, L, Singleton, A, Smith, Nl, Sovio, U, Swift, A, Syddall, H, Syvänen, Ac, Tanaka, T, Tönjes, A, Uitterlinden, Ag, van Dijk, Kw, Varma, D, Visvikis Siest, S, Vitart, V, Vogelzangs, N, Waeber, G, Wagner, Pj, Walley, A, Ward, Kl, Watkins, H, Wild, Sh, Willemsen, G, Witteman, Jc, Yarnell, Jw, Zelenika, D, Zethelius, B, Zhai, G, Zhao, Jh, Zillikens, Mc, Borecki, Ib, Loos, Rj, Meneton, P, Magnusson, Pk, Nathan, Dm, Williams, Gh, Silander, K, Salomaa, V, Smith, Gd, Bornstein, Sr, Schwarz, P, Spranger, J, Karpe, F, Shuldiner, Ar, Cooper, C, Dedoussis, Gv, Serrano Ríos, M, Lind, L, Palmer, Lj, Franks, Pw, Ebrahim, S, Marmot, M, Wright, Af, Stumvoll, M, Hamsten, A, Buchanan, Ta, Valle, Tt, Rotter, Ji, Siscovick, D, Penninx, Bw, Boomsma, Di, Deloukas, P, Spector, Td, Ferrucci, L, Cao, A, Scuteri, A, Schlessinger, D, Uda, M, Ruokonen, A, Jarvelin, Mr, Waterworth, Dm, Vollenweider, P, Peltonen, L, Mooser, V, Sladek, R., Medical Research Council (MRC), Human genetics, Psychiatry, NCA - Attention & Cognition, EMGO - Lifestyle, overweight and diabetes, Biological Psychology, Functional Genomics, Neuroscience Campus Amsterdam - Attention & Cognition, EMGO+ - Lifestyle, Overweight and Diabetes, Langenberg, Claudia [0000-0002-5017-7344], Griffin, Simon [0000-0002-2157-4797], Wareham, Nicholas [0000-0003-1422-2993], Soranzo, Nicole [0000-0003-1095-3852], Wheeler, Eleanor [0000-0002-8616-6444], Luan, Jian'an [0000-0003-3137-6337], Forouhi, Nita [0000-0002-5041-248X], Sharp, Stephen [0000-0003-2375-1440], Sovio, Ulla [0000-0002-0799-1105], Apollo - University of Cambridge Repository, DIAGRAM Consortium, MAGIC Investigators, Johnson, T., Bergman, S., Bochud, M., Waeber, G., and Vollenweider, P.

Subjects
Netherlands Twin Register (NTR), Male, Adult, African Americans/genetics, Aged, Case-Control Studies, Cohort Studies, Diabetes Mellitus, Type 2/ethnology, Diabetes Mellitus, Type 2/genetics, Female, Genetic Predisposition to Disease, Genome-Wide Association Study, Genotype, Humans, Meta-Analysis as Topic, Middle Aged, Polymorphism, Single Nucleotide, Validation Studies as Topic, Medicin och hälsovetenskap, Linkage disequilibrium, Genetic Screens, endocrine system diseases, lcsh:Medicine, Genome-wide association study, Medical and Health Sciences, 0302 clinical medicine, Endocrinology, Genome Sequencing, lcsh:Science, Medicine(all), Genetics, African Americans, 0303 health sciences, education.field_of_study, INSULIN-RESISTANCE, Multidisciplinary, Agricultural and Biological Sciences(all), LARGE-SCALE ASSOCIATION, STAGE RENAL-DISEASE, COMMON VARIANTS, Genomics, Medicine, Research Article, SUSCEPTIBILITY LOCI, General Science & Technology, Population, Single-nucleotide polymorphism, Biology, DIAGRAM Consortium, 03 medical and health sciences, MAGIC Investigators, SDG 3 - Good Health and Well-being, Genetic linkage, MD Multidisciplinary, Genome-Wide Association Studies, SNP, ddc:610, education, Genotyping, 030304 developmental biology, Diabetic Endocrinology, LINKAGE ANALYSIS, Biochemistry, Genetics and Molecular Biology(all), lcsh:R, TCF7L2 GENE, Case-control study, Computational Biology, nutritional and metabolic diseases, Human Genetics, Diabetes Mellitus Type 2, Stage renal-disease, large-scale association, Susceptibility loci, Insulin-resistance, Fasting glucose, Tissue factor, Homeodomain protein, Linkage analysis, Common variants, TCF7L2 gene, Black or African American, Diabetes Mellitus, Type 2, TISSUE FACTOR, Genetics of Disease, HOMEODOMAIN PROTEIN, Genetic Polymorphism, lcsh:Q, Genome Expression Analysis, 030217 neurology & neurosurgery, Population Genetics, FASTING GLUCOSE
Abstract

African Americans are disproportionately affected by type 2 diabetes (T2DM) yet few studies have examined T2DM using genome-wide association approaches in this ethnicity. The aim of this study was to identify genes associated with T2DM in the African American population. We performed a Genome Wide Association Study (GWAS) using the Affymetrix 6.0 array in 965 African-American cases with T2DM and end-stage renal disease (T2DM-ESRD) and 1029 population-based controls. The most significant SNPs (n = 550 independent loci) were genotyped in a replication cohort and 122 SNPs (n = 98 independent loci) were further tested through genotyping three additional validation cohorts followed by meta-analysis in all five cohorts totaling 3,132 cases and 3,317 controls. Twelve SNPs had evidence of association in the GWAS (P

Published
2012

174. Screening for Type 2 diabetes. Lessons from the ADDITION-Europe study

Author

van den Donk, Maureen, Sandbæk, Annelli, Lauritzen, Torsten, Simmons, Rebecca K, Wareham, Nicholas J, Griffin, Simon J, Davies, Michael J, Khunti, Kamlesh, and Rutten, Guy E H M

Abstract

Aims: To describe and compare attendance rates and the proportions of people identified with Type 2 diabetes mellitus in people with previously unknown diabetes who participated in screening programmes undertaken in general practice in the UK, Denmark and the Netherlands as part of the ADDITION‐Europe study.Methods: In Cambridge, routine computer data searches were conducted to identify individuals aged 40–69 years at high risk of Type 2 diabetes using the Cambridge Diabetes Risk Score. In Denmark, the Danish Diabetes Risk Score was mailed to individuals aged 40–69 years, or completed by patients visiting their general practitice. In the Netherlands, the Hoorn Symptom Risk Questionnaire was mailed to individuals aged 50–69 years. In these three centres, high‐risk individuals were invited to attend subsequent steps in the screening programme, including random blood glucose, HbA1c, fasting blood glucose and/or oral glucose tolerance test. In Leicester, eligible people aged 40–69 years were invited directly for an oral glucose tolerance test. In all centres, Type 2 diabetes was defined according to World Health Organization 1999 diagnostic criteria.Results: Attendance rates ranged from 20.2% (oral glucose tolerance test in Leicester without pre‐stratification) to 95.1% (random blood glucose in opportunistic screening in Denmark in high‐risk people). The percentage of people with newly detected Type 2 diabetes from the target population ranged from 0.33% (Leicester) to 1.09% (the Netherlands).Conclusions: Screening for Type 2 diabetes was acceptable and feasible, but relatively few participants were diagnosed in all participating centres. Different strategies may be required to increase initial attendance and ensure completion of screening programmes.

Published
2011

185. Lifting the lid of the 'Black intervention box' -the systematic development of an action competence programme for people with screen-detected dysglycaemia

Author

Maindal, Helle Terkildsen, Kirkevold, Marit, Sandbæk, Annelli, and Lauritzen, Torsten

Abstract

Background: The evidence gained from effective self-management interventions is often criticised for the ambiguity of its active components, and consequently the obstruction of their implementation into daily practice. Our aim is to report how an intervention development model aids the careful selection of active components in an intervention for people with dysglycaemia. Methods: The first three phases of the UK Medical Research Council's model for developing complex interventions in primary care were used to develop a self-management intervention targeting people with screen-detected dysglycaemia. In the preclinical phase, the expected needs of the target group were assessed by review of empirical literature and theories. In phase I, a preliminary intervention was modelled and in phase II, the preliminary intervention was pilot tested. Results: In the preclinical phase the achievement of health-related action competence was defined as the overall intervention goal and four learning objectives were identified: motivation, informed decision-making, action experience and social involvement. In Phase I, the educational activities were defined and the pedagogical tools tested. In phase II, the intervention was tested in two different primary healthcare settings and adjusted accordingly. The 18- hour intervention "Ready to Act" ran for 3 months and consisted of two motivational one-to-one sessions conducted by nurses and eight group meetings conducted by multidisciplinary teams. Conclusions: An intervention aimed at health-related action competence was successfully developed for people with screen-detected dysglycaemia. The systematic and transparent developmental process is expected to facilitate future clinical research. The MRC model provides the necessary steps to inform intervention development but should be prioritised according to existing evidence in order to save time

Published
2010

186. Whole-Exome Sequencing of 2,000 Danish Individuals and the Role of Rare Coding Variants in Type 2 Diabetes

Author

Lohmueller, Kirk E, Lohmueller, Kirk E, Sparsø, Thomas, Li, Qibin, Andersson, Ehm, Korneliussen, Thorfinn, Albrechtsen, Anders, Banasik, Karina, Grarup, Niels, Hallgrimsdottir, Ingileif, Kiil, Kristoffer, Kilpeläinen, Tuomas O, Krarup, Nikolaj T, Pers, Tune H, Sanchez, Gaston, Hu, Youna, DeGiorgio, Michael, Jørgensen, Torben, Sandbæk, Annelli, Lauritzen, Torsten, Brunak, Søren, Kristiansen, Karsten, Li, Yingrui, Hansen, Torben, Wang, Jun, Nielsen, Rasmus, Pedersen, Oluf, Lohmueller, Kirk E, Lohmueller, Kirk E, Sparsø, Thomas, Li, Qibin, Andersson, Ehm, Korneliussen, Thorfinn, Albrechtsen, Anders, Banasik, Karina, Grarup, Niels, Hallgrimsdottir, Ingileif, Kiil, Kristoffer, Kilpeläinen, Tuomas O, Krarup, Nikolaj T, Pers, Tune H, Sanchez, Gaston, Hu, Youna, DeGiorgio, Michael, Jørgensen, Torben, Sandbæk, Annelli, Lauritzen, Torsten, Brunak, Søren, Kristiansen, Karsten, Li, Yingrui, Hansen, Torben, Wang, Jun, Nielsen, Rasmus, and Pedersen, Oluf

Published
2014

187. A combined analysis of 48 type 2 diabetes genetic risk variants shows no discriminative value to predict time to first prescription of a glucose lowering drug in Danish patients with screen detected type 2 diabetes.

Author

Hornbak, Malene, Allin, Kristine Højgaard, Jensen, Majken Linnemann, Lau, Cathrine J, Witte, Daniel R, Jørgensen, Marit Eika, Sandbæk, Annelli, Lauritzen, Torsten, Andersson, Åsa, Pedersen, Oluf Borbye, Hansen, Torben, Hornbak, Malene, Allin, Kristine Højgaard, Jensen, Majken Linnemann, Lau, Cathrine J, Witte, Daniel R, Jørgensen, Marit Eika, Sandbæk, Annelli, Lauritzen, Torsten, Andersson, Åsa, Pedersen, Oluf Borbye, and Hansen, Torben

Published
2014

188. Stability of the Associations between Early Life Risk Indicators and Adolescent Overweight over the Evolving Obesity Epidemic

Author

Graversen, Lise, Sørensen, Thorkild I A, Petersen, Liselotte, Sovio, Ulla, Kaakinen, Marika, Sandbæk, Annelli, Laitinen, Jaana, Taanila, Anja, Pouta, Anneli, Järvelin, Marjo-Riitta, Obel, Carsten, Graversen, Lise, Sørensen, Thorkild I A, Petersen, Liselotte, Sovio, Ulla, Kaakinen, Marika, Sandbæk, Annelli, Laitinen, Jaana, Taanila, Anja, Pouta, Anneli, Järvelin, Marjo-Riitta, and Obel, Carsten

Abstract

BACKGROUND: Pre- and perinatal factors and preschool body size may help identify children developing overweight, but these factors might have changed during the development of the obesity epidemic.OBJECTIVE: We aimed to assess the associations between early life risk indicators and overweight at the age of 9 and 15 years at different stages of the obesity epidemic.METHODS: We used two population-based Northern Finland Birth Cohorts including 4111 children born in 1966 (NFBC1966) and 5414 children born in 1985-1986 (NFBC1986). In both cohorts, we used the same a priori defined prenatal factors, maternal body mass index (BMI), birth weight, infant weight (age 5 months and 1 year), and preschool BMI (age 2-5 years). We used internal references in early childhood to define percentiles of body size (<50, 50-75, 75-90 and >90) and generalized linear models to study the association with overweight, according to the International Obesity Taskforce (IOTF) definitions, at the ages of 9 and 15 years.RESULTS: The prevalence of overweight at the age of 15 was 9% for children born in 1966 and 16% for children born in 1986. However, medians of infant weight and preschool BMI changed little between the cohorts, and we found similar associations between maternal BMI, infant weight, preschool BMI, and later overweight in the two cohorts. At 5 years, children above the 90th percentile had approximately a 12 times higher risk of being overweight at the age of 15 years compared to children below the 50th percentile in both cohorts.CONCLUSIONS: The associations between early body size and adolescent overweight showed remarkable stability, despite the increase in prevalence of overweight over the 20 years between the cohorts. Using consequently defined internal percentiles may be a valuable tool in clinical practice.

Published
2014

189. Preschool Weight and Body Mass Index in Relation to Central Obesity and Metabolic Syndrome in Adulthood

Author

Graversen, Lise, Sørensen, Thorkild I A, Petersen, Liselotte, Sovio, Ulla, Kaakinen, Marika, Sandbaek, Annelli, Laitinen, Jaana, Taanila, Anja, Pouta, Anneli, Järvelin, Marjo-Riitta, Obel, Carsten, Graversen, Lise, Sørensen, Thorkild I A, Petersen, Liselotte, Sovio, Ulla, Kaakinen, Marika, Sandbaek, Annelli, Laitinen, Jaana, Taanila, Anja, Pouta, Anneli, Järvelin, Marjo-Riitta, and Obel, Carsten

Abstract

BACKGROUND: If preschool measures of body size routinely collected at preventive health examinations are associated with adult central obesity and metabolic syndrome, a focused use of these data for the identification of high risk children is possible. The aim of this study was to test the associations between preschool weight and body mass index (BMI) and adult BMI, central obesity and metabolic alterations.METHODS: The Northern Finland Birth Cohort 1966 (NFBC1966) (N = 4111) is a population-based cohort. Preschool weight (age 5 months and 1 year) and BMI (age 2-5 years) were studied in relation to metabolic syndrome as well as BMI, waist circumference, lipoproteins, blood pressure, and fasting glucose at the age of 31 years. Linear regression models and generalized linear regression models with log link were used.RESULTS: Throughout preschool ages, weight and BMI were significantly linearly associated with adult BMI and waist circumference. Preschool BMI was inversely associated with high-density lipoprotein levels from the age of 3 years. Compared with children in the lower half of the BMI range, the group of children with the 5% highest BMI at the age of 5 years had a relative risk of adult obesity of 6.2(95% CI:4.2-9.3), of adult central obesity of 2.4(95% CI:2.0-2.9), and of early onset adult metabolic syndrome of 2.5(95% CI:1.7-3.8).CONCLUSIONS: High preschool BMI is consistently associated with adult obesity, central obesity and early onset metabolic syndrome. Routinely collected measures of body size in preschool ages can help to identify children in need of focused prevention due to their increased risk of adverse metabolic alterations in adulthood.

Published
2014

190. Børn og unges mentale helbred

Author

Due, Pernille, Diderichsen, Finn, Meilstrup, Charlotte Bjerre, Nordentoft, Merete, Obel, Carsten, Sandbæk, Annelli, Due, Pernille, Diderichsen, Finn, Meilstrup, Charlotte Bjerre, Nordentoft, Merete, Obel, Carsten, and Sandbæk, Annelli

Published
2014

191. Identification of low-frequency and rare sequence variants associated with elevated or reduced risk of type 2 diabetes

Author

Steinthorsdottir, Valgerdur, Thorleifsson, Gudmar, Sulem, Patrick, Helgason, Hannes, Grarup, Niels, Sigurdsson, Asgeir, Helgadottir, Hafdis T, Johannsdottir, Hrefna, Magnusson, Olafur T, Gudjonsson, Sigurjon A, Justesen, Johanne M, Harder, Marie N, Jørgensen, Marit E, Christensen, Cramer, Brandslund, Ivan, Sandbæk, Annelli, Lauritzen, Torsten, Vestergaard, Henrik, Linneberg, Allan, Jørgensen, Torben, Hansen, Torben, Daneshpour, Maryam S, Fallah, Mohammad-Sadegh, Hreidarsson, Astradur B, Sigurdsson, Gunnar, Azizi, Fereidoun, Benediktsson, Rafn, Masson, Gisli, Helgason, Agnar, Kong, Augustine, Gudbjartsson, Daniel F, Pedersen, Oluf, Thorsteinsdottir, Unnur, Stefansson, Kari, Steinthorsdottir, Valgerdur, Thorleifsson, Gudmar, Sulem, Patrick, Helgason, Hannes, Grarup, Niels, Sigurdsson, Asgeir, Helgadottir, Hafdis T, Johannsdottir, Hrefna, Magnusson, Olafur T, Gudjonsson, Sigurjon A, Justesen, Johanne M, Harder, Marie N, Jørgensen, Marit E, Christensen, Cramer, Brandslund, Ivan, Sandbæk, Annelli, Lauritzen, Torsten, Vestergaard, Henrik, Linneberg, Allan, Jørgensen, Torben, Hansen, Torben, Daneshpour, Maryam S, Fallah, Mohammad-Sadegh, Hreidarsson, Astradur B, Sigurdsson, Gunnar, Azizi, Fereidoun, Benediktsson, Rafn, Masson, Gisli, Helgason, Agnar, Kong, Augustine, Gudbjartsson, Daniel F, Pedersen, Oluf, Thorsteinsdottir, Unnur, and Stefansson, Kari

Abstract

Through whole-genome sequencing of 2,630 Icelanders and imputation into 11,114 Icelandic cases and 267,140 controls followed by testing in Danish and Iranian samples, we discovered 4 previously unreported variants affecting risk of type 2 diabetes (T2D). A low-frequency (1.47%) variant in intron 1 of CCND2, rs76895963[G], reduces risk of T2D by half (odds ratio (OR) = 0.53, P = 5.0 × 10(-21)) and is correlated with increased CCND2 expression. Notably, this variant is also associated with both greater height and higher body mass index (1.17 cm per allele, P = 5.5 × 10(-12) and 0.56 kg/m(2) per allele, P = 6.5 × 10(-7), respectively). In addition, two missense variants in PAM, encoding p.Asp563Gly (frequency of 4.98%) and p.Ser539Trp (frequency of 0.65%), confer moderately higher risk of T2D (OR = 1.23, P = 3.9 × 10(-10) and OR = 1.47, P = 1.7 × 10(-5), respectively), and a rare (0.20%) frameshift variant in PDX1, encoding p.Gly218Alafs*12, associates with high risk of T2D (OR = 2.27, P = 7.3 × 10(-7)).

Published
2014

193. Adherence to guidelines in people with screen-detected type-2 diabetes, ADDITION, Denmark

Author

Juul, Lise, Sandbæk, Annelli, Foldspang, Anders, Frydenberg, Morten, Borch-Johnsen, Knut, and Lauritzen, Torsten

Subjects
general practice, ACE inhibitors, screening, Type 2 diabetes mellitus, family practice, guideline adherence, patient compliance
Abstract

Objective. In people with screen-detected type 2 diabetes in primary care, (1) to assess adherence to guidelines, recommending consultation with the GP every three months and treatment initiation with an ACE inhibitor or an angiotensin-II receptor antagonist when systolic BP was > 120 mmHg and/or diastolic BP was > 80 mmHg, and (2) to identify predictors for adherence. Design. Prospective follow-up of a fixed cohort of patients. Setting. Fifty-four Danish general practices. Subjects and main outcome measures. A total of 361 people with screen-detected type 2 diabetes were followed up for 410 days to assess planned consultations with their GP and recording of BP. Some 226 people, with BP recorded above guideline threshold(s) and where treatment was not already initiated, were followed for up to 410 days to monitor prescription redemption. Results. At 3, 6, 9 and 12 months 80%, 77%, 74%, and 73% of the cohort attended a consultation. A total of 89% of the cohort attended two of the four planned consultations. The probability of redeemed prescriptions for an ACE inhibitor or an angiotensin-II receptor antagonist according to the guideline during the first year following diagnosis was 51%. High initial BP was associated with prescription redemption. No other analysed individual or organisational characteristics were found to be associated with treatment initiation. Conclusion. The consultation attendance was reasonably high, and treatment initiation with an ACE inhibitor or an angiotensin-II receptor antagonist according to the guideline was found in half of the cases. High initial BP increased the probability of treatment initiation.

Published
2009

194. Association of variants in the sterol regulatory element-binding factor 1 gene (SREBF1) with type 2 diabetes, glycemia, and insulin resistance - A study of 15,734 Danish subjects

Author

Grarup, Niels, Stender-Petersen, Kirstine L, Andersson, Ehm A, Jørgensen, Torben, Borch-Johnsen, Knut, Sandbæk, Annelli, Lauritzen, Torsten, Schmitz, Ole, Hansen, Torben, and Pedersen, Oluf

Abstract

Objective: We evaluated association of variants in the sterol regulatory element-binding factor 1 gene (SREBF1) with type 2 diabetes. Due to the previous inconclusive quantitative trait associations, we also did studies of intermediate quantitative phenotypes. Research design and methods: We genotyped four variants in SREBF1 in the population-based Inter99 cohort (n=6,070), the Danish ADDITION study (n=8,662) and in additional type 2 diabetic patients (n=1,002). The case-control studies involved 2,980 type 2 diabetic patients and 4,522 glucose-tolerant subjects. Results: The minor alleles of the rs2297508, rs11868035 and rs1889018 (linkage disequilibrium R(2)=0.6-0.8) associated with a modestly increased risk of type 2 diabetes (rs2297508: OR 1.17 [95% CI 1.05-1.30], P=0.003) which was confirmed in meta-analyses of all published studies (rs2297508 G-allele: OR 1.08 [1.03-1.14] per allele, P=0.001). The diabetes-associated alleles also associated strongly with a higher plasma-glucose at 30 and 120 minutes and serum-insulin at 120 minutes during an OGTT (all P Udgivelsesdato: 2008-Feb-25

Published
2008

195. Exenatide--an alternative to insulin in the treatment of type 2 diabetes?

Author

Kjeldsen, Rasmus and Sandbaek, Annelli

Subjects
Adult, Blood Glucose, Evidence-Based Medicine, Treatment Outcome, Diabetes Mellitus, Type 2, Venoms, Weight Loss, Animals, Humans, Hypoglycemic Agents, Insulin, Peptides
Abstract

The benefits and drawbacks of exenatide as an alternative to insulin in the treatment of poorly regulated type 2 diabetes are reviewed. Exenatide and insulin have equal effects on HbA1c but exenatide causes weight-loss and improved postprandial glucose control. Nausea is reported by nearly half of patients treated with exenatide. Exenatide can be considered in the overweight patient without extremely elevated HbA1c but nausea could pose a substantial hurdle for successful treatment. Udgivelsesdato: 2008-Sep-22

Published
2008

197. Short-term reproducibility of impaired fasting glycaemia, impaired glucose tolerance and diabetes The ADDITION study, DK

Author

Rasmussen, S S, Glümer, C, Sandbæk, Annelli, Lauritzen, Torsten, Carstensen, Bendix, and Borch-Johnsen, Knut

Abstract

We evaluated variations in glucose measurements and the reproducibility of glucose tolerance classification in a high-risk screening setting in general practice. Screening for diabetes was performed in persons aged 40-69 years. Based on capillary fasting (FBG) and 2-h blood glucose (2hBG) individuals with impaired fasting glycaemia (IFG), impaired glucose tolerance (IGT) and diabetes had a second test done after 14 days. Intra-individual coefficients of variation (CV) were estimated in each glucose tolerance class using the approximation CV(2)(x)=var(ln(x)). Bland-Altman plots with limits of agreement were made. In the total population, the CV(intra) was 7.9% and 13.8% for FBG and 2hBG, respectively. Limits of agreement ranged from -1.15 to 1.67mmol/l for FBG and from - 2.62 to 3.27mmol/l for 2hBG. One individual with IFG and 22.5% with IGT had diabetes at the second test, 76.1% with diabetes had this diagnosis confirmed, and about 30% with IFG and IGT had normal glucose tolerance at the second test. The expected values of repeated capillary blood glucose measurements were about+/-1 and+/-3mmol/l for FBG and 2hBG, respectively. Yet, 70% of high-risk prediabetic individuals were persistently classified with abnormal glucose regulation; diabetes was confirmed in 76% of the cases. Udgivelsesdato: 2007-Dec-12

Published
2007

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