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Glycaemic control, disease duration and beta-cell function in patients with Type 2 diabetes in a Swedish community. Skaraborg Hypertension and Diabetes Project.

Östgren, Carl Johan LU ; Lindblad, Ulf LU ; Ranstam, Jonas LU ; Melander, Arne LU and Råstam, Lennart LU (2002) In Diabetic Medicine 19(2). p.125-129
Abstract
AimsTo examine determinants for glycaemic control in primary care patients with Type 2 diabetes.



MethodsIn a community-based surveillance of primary care patients with Type 2 diabetes, 190 men and 186 women were consecutively identified and examined for cardiovascular risk factors. Insulin resistance and beta-cell function were estimated using homeostasis model assessment (HOMA). Good glycaemic control was defined as HbA1c < 6.5%.



ResultsFollowing adjustment for age and gender, HbA1c>= 6.5% was associated with duration of diabetes (10.6 vs. 6.4 years, P < 0.001), lower levels of serum insulin (6.3 vs. 8.0 mU/l, P = 0.012), higher serum triglyceride levels (2.0 vs. 1.7 mmol/l, P = 0.002) and... (More)
AimsTo examine determinants for glycaemic control in primary care patients with Type 2 diabetes.



MethodsIn a community-based surveillance of primary care patients with Type 2 diabetes, 190 men and 186 women were consecutively identified and examined for cardiovascular risk factors. Insulin resistance and beta-cell function were estimated using homeostasis model assessment (HOMA). Good glycaemic control was defined as HbA1c < 6.5%.



ResultsFollowing adjustment for age and gender, HbA1c>= 6.5% was associated with duration of diabetes (10.6 vs. 6.4 years, P < 0.001), lower levels of serum insulin (6.3 vs. 8.0 mU/l, P = 0.012), higher serum triglyceride levels (2.0 vs. 1.7 mmol/l, P = 0.002) and impairment of beta-cell function (HOMA index 19.5 vs. 45.8, P < 0.001). The association between HbA1c levels and duration remained with adjustment for age, gender, waist-hip ratio (WHR) and serum triglycerides (odds ratio (OR) for HbA1c>= 6.5% by 5 years diabetes duration = 1.7; 95% confidence interval (CI) 1.4-2.1) but was lost following additional adjustment for beta-cell function (OR for HbA1c>= 6.5% = 1.3; 95% CI 0.96-1.7). In a separate linear regression with beta-cell function as the dependent variable there was a significant association with HbA1c after adjustments for differences in age, gender, WHR, serum triglyceride levels and diabetes duration (P < 0.001).



ConclusionsIncreasing HbA1c by time was associated with declining beta-cell function. (Less)
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publication status
published
subject
keywords
Human, Glycosylated: analysis, Hemoglobin A, Female, Non-Insulin-Dependent: blood, Aged, 8 Age of Onset, Diabetes Mellitus, Blood Pressure, Blood Glucose: metabolism, Cardiovascular Diseases: epidemiology, Diabetic Angiopathies: epidemiology, Non-Insulin-Dependent: physiopathology, Triglycerides: blood, Sweden, Support, Non-U.S. Gov't, Risk Factors, Male, Insulin: secretion, Insulin: blood, Islets of Langerhans: secretion
in
Diabetic Medicine
volume
19
issue
2
pages
125 - 129
publisher
Wiley-Blackwell
external identifiers
  • wos:000174576300007
  • pmid:11874428
  • scopus:0036125347
ISSN
1464-5491
DOI
10.1046/j.1464-5491.2002.00661.x
language
English
LU publication?
yes
id
2b97f49d-4357-41cf-b30e-d41e42849679 (old id 115541)
date added to LUP
2007-07-27 14:57:14
date last changed
2017-05-28 04:25:04
@article{2b97f49d-4357-41cf-b30e-d41e42849679,
  abstract     = {AimsTo examine determinants for glycaemic control in primary care patients with Type 2 diabetes.<br/><br>
<br/><br>
MethodsIn a community-based surveillance of primary care patients with Type 2 diabetes, 190 men and 186 women were consecutively identified and examined for cardiovascular risk factors. Insulin resistance and beta-cell function were estimated using homeostasis model assessment (HOMA). Good glycaemic control was defined as HbA1c &lt; 6.5%.<br/><br>
<br/><br>
ResultsFollowing adjustment for age and gender, HbA1c&gt;= 6.5% was associated with duration of diabetes (10.6 vs. 6.4 years, P &lt; 0.001), lower levels of serum insulin (6.3 vs. 8.0 mU/l, P = 0.012), higher serum triglyceride levels (2.0 vs. 1.7 mmol/l, P = 0.002) and impairment of beta-cell function (HOMA index 19.5 vs. 45.8, P &lt; 0.001). The association between HbA1c levels and duration remained with adjustment for age, gender, waist-hip ratio (WHR) and serum triglycerides (odds ratio (OR) for HbA1c&gt;= 6.5% by 5 years diabetes duration = 1.7; 95% confidence interval (CI) 1.4-2.1) but was lost following additional adjustment for beta-cell function (OR for HbA1c&gt;= 6.5% = 1.3; 95% CI 0.96-1.7). In a separate linear regression with beta-cell function as the dependent variable there was a significant association with HbA1c after adjustments for differences in age, gender, WHR, serum triglyceride levels and diabetes duration (P &lt; 0.001).<br/><br>
<br/><br>
ConclusionsIncreasing HbA1c by time was associated with declining beta-cell function.},
  author       = {Östgren, Carl Johan and Lindblad, Ulf and Ranstam, Jonas and Melander, Arne and Råstam, Lennart},
  issn         = {1464-5491},
  keyword      = {Human,Glycosylated: analysis,Hemoglobin A,Female,Non-Insulin-Dependent: blood,Aged,8
Age of Onset,Diabetes Mellitus,Blood Pressure,Blood Glucose: metabolism,Cardiovascular Diseases: epidemiology,Diabetic Angiopathies: epidemiology,Non-Insulin-Dependent: physiopathology,Triglycerides: blood,Sweden,Support,Non-U.S. Gov't,Risk Factors,Male,Insulin: secretion,Insulin: blood,Islets of Langerhans: secretion},
  language     = {eng},
  number       = {2},
  pages        = {125--129},
  publisher    = {Wiley-Blackwell},
  series       = {Diabetic Medicine},
  title        = {Glycaemic control, disease duration and beta-cell function in patients with Type 2 diabetes in a Swedish community. Skaraborg Hypertension and Diabetes Project.},
  url          = {http://dx.doi.org/10.1046/j.1464-5491.2002.00661.x},
  volume       = {19},
  year         = {2002},
}