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4. The Prevalence of Polyneuropathy in Type 2 Diabetes Subgroups Based on HOMA2 Indices of β-Cell Function and Insulin Sensitivity

Author

Kristensen, Frederik Pagh Bredahl, primary, Christensen, Diana Hedevang, additional, Callaghan, Brian Christopher, additional, Stidsen, Jacob Volmer, additional, Nielsen, Jens Steen, additional, Højlund, Kurt, additional, Beck-Nielsen, Henning, additional, Jensen, Troels Staehelin, additional, Andersen, Henning, additional, Vestergaard, Peter, additional, Jessen, Niels, additional, Olsen, Michael Hecht, additional, Hansen, Torben, additional, Brøns, Charlotte, additional, Vaag, Allan, additional, Sørensen, Henrik Toft, additional, and Thomsen, Reimar Wernich, additional

Published
2023
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5. Cohort Profile: Better Health in Late Life.

Author

Sørensen, Henrik Toft, Christensen, Tina, Bøtker, Hans Erik, Christiansen, Christian Fynbo, Fuglsang, Cecilia H, Gribsholt, Sigrid B, Kristensen, Frederik Pagh Bredahl, Laugesen, Kristina, Laursen, Anne Sofie D, Nørgaard, Mette, Schmidt, Morten, Skajaa, Nils, Troelsen, Frederikke S, and Pedersen, Lars

Subjects
CARDIOVASCULAR diseases, NEUROLOGICAL disorders, BODY composition, MEDICAL care, ALCOHOL drinking, BEVERAGES, HEALTH behavior
Abstract

Purpose: Humans are living longer and may develop multiple chronic diseases in later life. The Better Health in Late Life cohort study aims to improve our understanding of the risks and outcomes of multimorbidity in the Danish population.Methods: A randomly-selected sample of Danish residents who were 50– 65 years of age received a questionnaire and an invitation to participate in this study. Respondents completed an online survey between October 2021 and January 2022 which addressed topics that included self-assessed health, mental health, sleep, specific medical conditions, use of painkillers, diet, alcohol consumption, smoking, physical activity, and body composition. This information was linked to the Danish health and social registries (some established in 1943 and onwards) that maintain data on filled prescriptions, hospital records, socioeconomic status, and health care utilization.Results: Responses were received from 115,431 of the 301,244 residents invited to participate (38%). We excluded respondents who answered none of the questions as well as those who provided no information on sex or indicated an age other than 50– 65 years. Of the 114,283 eligible respondents, 54.8% were female, 30.3% were overweight, and 16.7% were obese. Most participants reported a weekly alcohol consumption of less than seven units and 13.3% were current smokers; 5.2% had a history of hospitalization for solid cancer, and 3.0%, 2.3%, 2.0%, and 0.9% reported chronic pulmonary disease, diabetes, stroke, and myocardial infarction, respectively. The most frequently filled prescriptions were for medications used to treat the nervous system and cardiovascular diseases (38.1% and 37.4%, respectively). [ABSTRACT FROM AUTHOR]

Published
2023
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6. The Prevalence of Polyneuropathy in Type 2 Diabetes Subgroups Based on HOMA2 Indices of β-Cell Function and Insulin Sensitivity

Author

Kristensen, Frederik Pagh Bredahl, Christensen, Diana Hedevang, Callaghan, Brian Christopher, Stidsen, Jacob Volmer, Nielsen, Jens Steen, Højlund, Kurt, Beck-Nielsen, Henning, Jensen, Troels Staehelin, Andersen, Henning, Vestergaard, Peter, Jessen, Niels, Olsen, Michael Hecht, Hansen, Torben, Brøns, Charlotte, Vaag, Allan, Sørensen, Henrik Toft, and Thomsen, Reimar Wernich

Abstract

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 β-cell function and insulin sensitivity.RESEARCH DESIGN AND METHODS: We estimated β-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 patients. After adjusting for demographics, diabetes duration and therapy, lifestyle behaviors, and metabolic syndrome components (waist circumference, triglycerides, 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.

Published
2023

7. Type 2 diabetes phenotypes and polyneuropathy:A prevalence study in the DD2 cohort

Author

Kristensen, Frederik Pagh Bredahl, Christensen, Diana Hedevang, Callaghan, Brian C., Svane, Helene Matilde Lundsgaard, Stidsen, Jakob, Nielsen, Jens Steen, Højlund, Kurt, Beck-Nielsen, Henning, Staehelin-Jensen, Troels, Andersen, Henning, Vestergaard, Peter, Jessen, Niels, Olsen, Michael Hecht, Hansen, Torben, Brøns, Charlotte, Vaag, Allan, Sørensen, Henrik Toft, and Thomsen, RW

Published
2022

9. Risk of mortality and recurrence after first-time stroke among patients with type 2 diabetes: A Danish nationwide cohort study

Author

Kristensen, Frederik Pagh Bredahl, Svane, Helene Matilde Lundsgaard, Laugesen, Kristina, Al-Mashhadi, Sofie Kejlberg, Christensen, Diana Hedevang, Sørensen, Henrik Toft, and Skajaa, Nils

Abstract

Introduction: The prognosis for stroke patients with type 2 diabetes mellitus (T2DM) remains poorly understood. We examined the risk of mortality and stroke recurrence in stroke patients with T2DM and stroke patients without diabetes.Patients and methods: We conducted a population-based cohort study including all patients diagnosed with a first-time ischemic stroke (n= 131,594) or intracerebral hemorrhage (ICH, n= 15,492) in Denmark, 2005–2021. Patients with T2DM were identified using hospital diagnosis codes and glucose-lowering drug prescriptions. We calculated risks, risk differences, and risk ratios, standardized by age, sex, and calendar year of stroke admission.Results: Following ischemic stroke, the 5-year standardized mortality was 46.1% for patients with T2DM and 35.4% for patients without diabetes (standardized risk difference: 10.7% [95% CI 9.9–11.6]; risk ratio: 1.3 [95% CI 1.3–1.3]). The 5-year risk of recurrence following ischemic stroke was 12.7% for patients with T2DM and 11.3% for those without diabetes (risk difference: 1.4% [95% CI 0.9–2.0]; risk ratio: 1.1 [95% CI 1.1–1.2]). Following ICH, the 5-year mortality was 62.8% for patients with T2DM and 53.0% for patients without diabetes (risk difference: 9.8% [95% CI 7.2–12.4)]; risk ratio: 1.2 [95% CI 1.1–1.2]). The 5-year risk of recurrence after ICH was 9.1% for patients with T2DM and 9.7% for patients without diabetes.Discussion and conclusion: Stroke patients with T2DM were at increased risk of mortality. The risk of stroke recurrence was slightly higher for ischemic stroke patients with T2DM than patients without diabetes, while no difference was observed among ICH patients.

Published
2024
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