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Prevalence and incidence rate of diabetes mellitus in a Swedish community during 30 years of follow-up
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
2007 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 50, no 4, 703-710 p.Article in journal (Refereed) Published
Abstract [en]

Aims/hypothesis: Increasing diabetes prevalence has been reported in most European countries in the last 20 years. In this study we report on the development of prevalence and incidence of diabetes from 1972 to 2001 in Laxå, a rural community in central Sweden. Materials and methods: A diabetes register was established at the primary healthcare centre (PHCC) in Laxå, beginning in 1972 and based on data from clinical records at the PHCC, nearby hospitals and private practitioners in the area. In addition, case-finding procedures involving 85% of the residents aged 35 to 79 years old was performed from 1983 onwards. Results: During the study period a total of 776 new diabetes cases was found, 36 type 1 diabetes mellitus and 740 type 2 diabetes mellitus. The age-standardised incidence rates for type 1 diabetes mellitus and type 2 diabetes mellitus were 0.15 and 3.03 cases per 1,000 population, respectively. No increase in incidence over time was detected for either forms of diabetes. Age-standardised prevalence for women and men increased from 28.3 and 25.9, respectively, per 1,000 in 1972 to 45 and 46.3 per 1,000 in 1988 (p<0.0001), thereafter falling to a mean of 43.5 per 1,000 for women, while men had a mean of 44.9 per 1,000 for the rest of the study period. Conclusions/interpretation: The prevalence of diabetes mellitus in Laxå is high, but has not increased during the last 13 years. The incidence rate was relatively stable over the whole 30-year period.

Place, publisher, year, edition, pages
2007. Vol. 50, no 4, 703-710 p.
Keyword [en]
Case-finding, Diabetes mellitus, Incidence, Prevalence, Time trend
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-10365DOI: 10.1007/s00125-007-0593-4ISI: 000244687700002PubMedID: 17268796OAI: oai:DiVA.org:uu-10365DiVA: diva2:38133
Available from: 2007-03-21 Created: 2007-03-21 Last updated: 2017-12-11Bibliographically approved
In thesis
1. A Longitudinal Study of Diabetes Mellitus: With Special Reference to Incidence and Prevalence, and to Determinants of Macrovascular Complications and Mortality
Open this publication in new window or tab >>A Longitudinal Study of Diabetes Mellitus: With Special Reference to Incidence and Prevalence, and to Determinants of Macrovascular Complications and Mortality
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Objectives. To investigate diabetes prevalence, incidence, mortality trends, the effects of hyperglycaemia and blood pressure, diabetes and hypertension treatment, and the effect of screening detection on total and cardiovascular disease (CVD), myocardial infarction (MI) and stroke incidence.

Study population and methods. Between 1972 and 2001 all patients with diabetes, some detected clinically and some by case-finding procedures (screening), were entered in a diabetes register at Laxå Primary Health Care Center in Sweden. The register included information on medical treatment and laboratory data as well as information on mortality and morbidity from National Registers. The register was supplemented with five non-diabetic subjects, matched to each diabetes patients by age, sex, and year of detection.

Results. During the study period 776 new diabetes cases was found, 36 type 1 diabetes mellitus and 740 type 2 diabetes mellitus. Age standardised incidence and prevalence rates for type 1 and type 2 diabetes did not increase over time. Diabetic patients had 17% higher mortality rate than non-diabetic persons, 22% in women and 13% in men. The corresponding over-mortality in CVD was 33%, 41% in women and 27% in men. CVD mortality decreased across time in non-diabetic subjects and in diabetic men but not in diabetic women. Results regarding coronary heart disease (CHD) were similar. CVD incidence increased with fasting blood glucose (FBG), body mass index (BMI), mean arterial blood pressure (MABP), and decreased with metformin treatment and sulfonylurea. Myocardial infarction incidence increased with FBG, BMI and MABP, and decreased with metformin treatment. Stroke incidence increased with MABP. There was no difference in prognoses between those detected by screening or clinically.

Conclusions. Diabetes prevalence and incidence did not change over time. The over-mortality according to diabetes was moderate. CVD and MI during follow up were negatively affected by hypertension and hyperglycaemia, and positively by pharmacological diabetic treatment. For stroke no pharmacological protective effect was seen. Screening did not improve prognosis.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2014. 132 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 955
Keyword
Diabetes mellitus, clinical epidemiology, longitudinal study, prevalence, incidence, mortality, macrovascular complications, pharmacological diabetes treatment, hypertension treatment, screening
National Category
Family Medicine
Research subject
Family Medicine
Identifiers
urn:nbn:se:uu:diva-210916 (URN)978-91-554-8819-2 (ISBN)
Public defence
2014-01-17, Wilandersalen, Universitetssjukhuset, Örebro, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2013-12-18 Created: 2013-11-17 Last updated: 2014-01-24

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