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  • 1
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    Online Resource
    The Incidence of Retinopathy 10 Years After Diagnosis in Young Adult People With Diabetes
    American Diabetes Association ; 2003
    In:  Diabetes Care Vol. 26, No. 2 ( 2003-02-01), p. 349-354
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 26, No. 2 ( 2003-02-01), p. 349-354
    Abstract: OBJECTIVE—To estimate the prevalence and severity of diabetic retinopathy (DR) 10 years after diagnosis in a nationwide population-based cohort study of young adult diabetic patients in Sweden. RESEARCH DESIGN AND METHODS—The Diabetes Incidence Study in Sweden (DISS) aims to register all incident cases of diabetes aged 15–34 years in Sweden. In 1987–1988, 806 cases were reported, and 627 (78%) of them were followed up with regard to retinopathy 8–10 years later. The assessment was based on retinal photographs in most cases (86%). RESULTS—Ten years after diagnosis, retinopathy was found in 247 patients (39%). The retinopathy was mild in 206 (33%), whereas 30 (4.8%) patients had moderate nonproliferative DR (NPDR) and 11 (1.8%) had proliferative DR (PDR). Patients with retinopathy had worse glycemic control during the years than patients without (HbA1c 8.1 ± 1.5% and 6.8 ± 1.2%, respectively; P & lt; 0.001). In a Cox regression analysis, time to retinopathy was related to high HbA1c (P & lt; 0.001) and high BMI (P = 0.001). Patients with type 2 diabetes had an increased prevalence of severe retinopathy (NPDR or PDR) compared with those with type 1 diabetes (14 of 93 [15%] versus no or mild 24 of 471 [5%] , respectively; P & lt; 0.001). CONCLUSIONS—Despite modern diabetes management, 39% of young adult diabetic patients developed retinopathy within the first 10 years of the disease. Nevertheless, compared with the prevalence of retinopathy (63%), after a similar duration of diabetes before the Diabetes Control and Complications Trial, this prevalence was clearly lower. Current treatment aimed to achieve strict glycemic control has reduced the risk for developing retinopathy.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.26.2.349
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2003
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  • 2
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    Online Resource
    Family Characteristics and Life Events Before the Onset of Autoimmune Type 1 Diabetes in Young Adults
    American Diabetes Association ; 2001
    In:  Diabetes Care Vol. 24, No. 6 ( 2001-06-01), p. 1033-1037
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 24, No. 6 ( 2001-06-01), p. 1033-1037
    Abstract: OBJECTIVE—To elucidate whether family characteristics and stressful life events were associated with onset of autoimmune type 1 diabetes in young adults. RESEARCH DESIGN AND METHODS—This investigation was based on a nationwide study (Diabetes Incidence Study in Sweden) of newly diagnosed patients aged 15–34 years. Patients clinically classified as type 1 diabetic with antibodies to islet cells and/or to GAD65 were compared with age- and sex-matched control subjects via questionnaire. The questionnaire covered diabetes heredity, social environment, educational level, and life events experienced during the 12 months before diagnosis. RESULTS—The rate of response was 82% for the diabetic patients and 65% for the control subjects. Questionnaires from 349 diabetic patients and 979 control subjects were considered. Diabetes in relatives was more frequent in the patients (odds ratio [OR]2.6) who were born in Sweden and whose mothers were of Swedish origin. No major stress factors were detected in the diabetic patients; however, in comparison with the control subjects, the diabetic patients had experienced fewer conflicts with their parents and had less often broken contacts with friends. CONCLUSIONS—Young adults with recent-onset type 1 diabetes were more exposed to heredity for diabetes, but no major prediabetic stress factors were detected. Our study does not directly support the concept that psychosocial stressful life events are involved in the development of autoimmune type 1 diabetes in young adults.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.24.6.1033
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2001
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  • 3
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    Online Resource
    Signs of Nephropathy May Occur Early in Young Adults With Diabetes Despite Modern Diabetes Management
    American Diabetes Association ; 2003
    In:  Diabetes Care Vol. 26, No. 10 ( 2003-10-01), p. 2903-2909
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 26, No. 10 ( 2003-10-01), p. 2903-2909
    Abstract: OBJECTIVE—To estimate the occurrence of early-onset renal involvement in a nationwide population-based cohort of young adults with diabetes in Sweden and relate the findings to glycemic control, type of diabetes, sex, smoking, and blood pressure. RESEARCH DESIGN AND METHODS—The Diabetes Incidence Study in Sweden aims to register all incident cases of diabetes in the age-group 15–34 years. In 1987–1988, 806 patients were reported and invited to participate in a follow-up study focusing on microvascular complications. Of them, 469 subjects participated. The assessment was based on questionnaires (n = 469), blood samples (n = 424), urine samples (n = 251) and, when appropriate, medical records (n = 186). RESULTS—During the follow-up time, median 9 years (range 6–12), 31 of 469 patients (6.6%) with incipient or overt diabetic nephropathy (i.e., micro- or macroalbuminuria) were found, 24 of 426 (5.6%) in type 1 and 7 of 43 (16%) in type 2 diabetic subjects (P = 0.016). Additionally, 24 of 31 patients (77%) had microalbuminuria and 7 (23%) had macroalbuminuria, which mainly occurred in patients with type 2 diabetes. In a Cox regression analysis, high mean HbA1c during the follow-up period and high blood pressure at follow-up increased the risk of developing signs of nephropathy (P = 0.020 and P = 0.003, respectively). Compared with patients with type 1 diabetes, those with type 2 diabetes tended to have an increased risk of renal involvement (P = 0.054) when adjusting for sex, tobacco use, glycemic control, and blood pressure. CONCLUSIONS—Despite modern treatment and self-monitoring of blood glucose, young adult patients with diabetes may still develop renal involvement during the first 10 years of diabetes duration. Inadequate HbA1c, high blood pressure, and type 2 diabetes appear to be risk markers for early occurrence of diabetic nephropathy.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.26.10.2903
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2003
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  • 4
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    Online Resource
    Genetic Effects on Age-Dependent Onset and Islet Cell Autoantibody Markers in Type 1 Diabetes
    American Diabetes Association ; 2002
    In:  Diabetes Vol. 51, No. 5 ( 2002-05-01), p. 1346-1355
    Details
    In: Diabetes, American Diabetes Association, Vol. 51, No. 5 ( 2002-05-01), p. 1346-1355
    Abstract: Age-dependent associations between type 1 diabetes risk genes HLA, INS VNTR, and CTLA-4 and autoantibodies to GAD65 (GADAs), ICA512/IA-2, insulin, and islet cells were determined by logistic regression analysis in 971 incident patients with type 1 diabetes and 702 control subjects aged 0–34 years. GADAs were associated with HLA-DQ2 in young but not in older patients (P = 0.009). Autoantibodies to insulin were negatively associated with age (P & lt; 0.0001) but positively associated with DQ8 (P = 0.03) and with INS VNTR (P = 0.04), supporting possible immune tolerance induction. ICA512/IA-2 were negatively associated with age (P & lt; 0.0001) and with DQ2 (P & lt; 0.0001) but positively associated with DQ8 (P = 0.04). Males were more likely than females to be negative for GADA (P & lt; 0.0001), autoantibodies to islet cells (P = 0.04), and all four autoantibody markers (P = 0.004). The CTLA-4 3′ end microsatellite marker was not associated with any of the autoantibodies. We conclude that age and genetic factors such as HLA-DQ and INS VNTR need to be combined with islet autoantibody markers when evaluating the risk for type 1 diabetes development.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    URL: Article
    DOI: 10.2337/diabetes.51.5.1346
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2002
    detail.hit.zdb_id: 1501252-9
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  • 5
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    Online Resource
    Measurement of antibodies against glutamic acid decarboxylase 65 (GADA): two new 125I assays compared with [35S]GAD 65-ligand binding assay
    Oxford University Press (OUP) ; 1997
    In:  Clinical Chemistry Vol. 43, No. 5 ( 1997-05-01), p. 779-785
    Details
    In: Clinical Chemistry, Oxford University Press (OUP), Vol. 43, No. 5 ( 1997-05-01), p. 779-785
    Abstract: Recently, 65-kDa glutamic acid decarboxylase (GAD 65) antibodies (GADA) have been introduced as autoimmune markers in blood to confirm the diagnosis of insulin-dependent diabetes mellitus (IDDM). In this study, to evaluate two new assays that use 125I-labeled GAD 65, we assayed samples from 100 children with recent onset of diabetes and 100 control children; the results were compared with those of a [35S]GADA assay and with results for islet cell antibodies (ICA), the conventional autoimmune marker. Receiver operating characteristic (ROC) curve analysis showed one of the new assays (from RSR) to be more sensitive (P = 0.01) than the comparison ([35S] GADA) assay, whereas the second new assay (from Elias) was less sensitive (P & lt;0.001). The GADA frequency at 97.5% specificity was greatest in the comparison assay: 63 of 100 vs 41 of 100 (P & lt; 0.01) and 53 of 100 (P = 0.16) in the RSR and Elias assays, respectively. Almost all GADA-positive patients had ICA, but one-third of the ICA-positive patients was GADA-negative. Accordingly, adding GADA analysis results to ICA testing increased the frequency of detection of autoimmune markers only slightly (from 81% to 85%). In conclusion, at 97.5% specificity the [35S]GADA assay seemed to be more efficient than the 125I assays, although the difference was significant only for the Elias 125I assay. Antigen-specific antibodies other than GADA may explain the difference in GADA and ICA frequencies.
    Type of Medium: Online Resource
    ISSN: 0009-9147 , 1530-8561
    URL: Article
    DOI: 10.1093/clinchem/43.5.779
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 1997
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  • 6
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    Protein tyrosine phosphatase-like protein IA2-antibodies plus glutamic acid decarboxylase 65 antibodies (GADA) indicates autoimmunity as frequently as islet cell antibodies assay in children with recently diagnosed diabetes mellitus
    Oxford University Press (OUP) ; 1997
    In:  Clinical Chemistry Vol. 43, No. 12 ( 1997-12-01), p. 2358-2363
    Details
    In: Clinical Chemistry, Oxford University Press (OUP), Vol. 43, No. 12 ( 1997-12-01), p. 2358-2363
    Abstract: Islet cell antibodies (ICA), the classical autoimmunity marker for insulin-dependent diabetes mellitus (IDDM), are detected in ∼85% of children with recently diagnosed diabetes. Because the ICA assay is semiquantitative and difficult to standardize, alternative assays are needed. When glutamic acid decarboxylase 65 (GAD 65) was discovered as a major islet antigen, the measurement of antibodies to GAD 65 (GADA) was considered a good alternative to ICA. Recently, however, we showed that 1 in 3 ICA-positive diabetic patients do not have GADA. Now, antibodies against the protein tyrosine phosphatase-like protein IA2 (IA2-ab) have been detected in IDDM. To find out whether measurements of IA2-ab combined with those of GADA could detect autoimmunity to the same extent as ICA, we have measured all three kinds of antibodies (using radioligand binding assays for IA2-ab and GADA) in 100 recently diagnosed diabetic and 100 control children: ICA were found in 87, IA2-ab in 69, and GADA in 66 of the 100 diabetic patients, whereas in the 100 control children ICA were found in 2, IA2-ab in 1, and GADA in 3. Among the 87 ICA-positive patients, 45 (52%) had both IA2-ab and GADA, 21 (24%) had only IA2-ab, and 16 (18%) had only GADA, whereas 5 (6%) lacked both IA2-ab and GADA. Among the 13 ICA-negative patients, 1 (8%) had both IA2-ab and GADA, 2 (15%) had only IA2-ab, and 4 (31%) had only GADA. Thus, 6 of the 100 patients had neither ICA, IA2-ab, nor GADA. Combining the IA2-ab and GADA assays gave positive results for autoimmunity in 89 of the 100 patients, compared with 87 by the ICA assay. The combination of the IA2-ab and GADA assays appears to be an effective alternative to the ICA assay.
    Type of Medium: Online Resource
    ISSN: 0009-9147 , 1530-8561
    URL: Article
    DOI: 10.1093/clinchem/43.12.2358
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 1997
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  • 7
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    Progression of Retinopathy in Insulin-Treated Type 2 Diabetic Patients
    American Diabetes Association ; 2002
    In:  Diabetes Care Vol. 25, No. 2 ( 2002-02-01), p. 381-385
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 25, No. 2 ( 2002-02-01), p. 381-385
    Abstract: OBJECTIVE—To study the progression of retinopathy 3 years after initiation of insulin therapy. RESEARCH DESIGN AND METHODS—In a prospective, observational case-control study, 42 type 2 diabetic patients were examined at baseline and 1, 3, 6, 12, 24, and 36 months after change to insulin therapy. Retinopathy was graded based on fundus photographs using the Wisconsin scale; HbA1c and IGF-1 were measured. RESULTS—During the observation period of 3 years, 26 patients progressed in the retinopathy scale; 11 patients progressed at least three levels. After 3 years of insulin therapy, HbA1c and IGF-1 were significantly lower than at baseline. Progression of retinopathy greater than or equal to three levels was related to high IGF-1 levels. CONCLUSIONS—A relationship was found between high IGF-1 levels at 3 years and progression of retinopathy in type 2 diabetic patients.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.25.2.381
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2002
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  • 8
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    Sympathetic and Parasympathetic Neuropathy Are Frequent in Both Type 1 and Type 2 Diabetic Patients
    American Diabetes Association ; 2004
    In:  Diabetes Care Vol. 27, No. 12 ( 2004-12-01), p. 2936-2941
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 27, No. 12 ( 2004-12-01), p. 2936-2941
    Abstract: OBJECTIVE—The aim of this study was to evaluate the frequency of sympathetic versus parasympathetic neuropathy among type 1 and type 2 diabetic patients. RESEARCH DESIGN AND METHODS—There were 43 patients with type 1 and 17 with type 2 diabetes who were investigated. Sympathetic nerve function was assessed by measurement of the vasoconstriction (VAC) index by laser Doppler perfusion imaging of a locally heated finger followed by indirect cooling. Parasympathetic nerve function was assessed by R-R interval variation during deep breathing as measured by the expiration/inspiration (E/I) ratio. Results were expressed as age-corrected z scores in SD; VAC index & gt;1.64 SD and E/I ratio & lt;−1.64 SD were considered abnormal. RESULTS—VAC index was abnormal in 40% with type 1 and 41% with type 2 diabetes, whereas the E/I ratio was abnormal in 42% with type 1 and 65% with type 2 diabetes. There was a clear association between VAC index and E/I ratio among type 1 (rs = 0.525; P = 0.0002) but not among type 2 (rs = 0.10) diabetic patients. Among type 2 diabetic patients, the degree of dysfunction was most severe regarding parasympathetic function (P = 0.0167). CONCLUSIONS—Sympathetic and parasympathetic neuropathy were frequent in both type 1 and type 2 diabetic patients. However, there was a difference between the two types of diabetes. Sympathetic and parasympathetic nerve functions correlated in type 1 but not in type 2 diabetic patients. The explanation for this discrepancy might be that parasympathetic nerve function was most severely affected among type 2 diabetic patients.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.27.12.2936
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2004
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  • 9
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    Online Resource
    Autonomic Nerve Function in Rheumatoid Arthritis of Varying Severity
    Informa UK Limited ; 1983
    In:  Scandinavian Journal of Rheumatology Vol. 12, No. 2 ( 1983-01), p. 166-170
    Details
    In: Scandinavian Journal of Rheumatology, Informa UK Limited, Vol. 12, No. 2 ( 1983-01), p. 166-170
    Type of Medium: Online Resource
    ISSN: 0300-9742 , 1502-7732
    URL: Article
    DOI: 10.3109/03009748309102905
    RVK:
    XA 10000
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 1983
    detail.hit.zdb_id: 1497111-2
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  • 10
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    Reply to: What is the mechanism behind the association between autoantibodies against GAD65 and high body mass index?
    Wiley ; 2004
    In:  Journal of Internal Medicine Vol. 256, No. 3 ( 2004-09), p. 264-264
    Details
    In: Journal of Internal Medicine, Wiley, Vol. 256, No. 3 ( 2004-09), p. 264-264
    Type of Medium: Online Resource
    ISSN: 0954-6820 , 1365-2796
    URL: Issue
    URL: Article
    DOI: 10.1111/jim.2004.256.issue-3
    DOI: 10.1111/j.1365-2796.2004.01385.x
    RVK:
    XA 54380
    Language: English
    Publisher: Wiley
    Publication Date: 2004
    detail.hit.zdb_id: 2006883-9
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