12 research outputs found
London calling?: Preferred emigration destinations among Icelandic youth
Post-print (lokagerð höfundar)Preferred emigration destinations among adolescents reflect images and stereotypes of other countries that continuously emerge in a multitude of local and global discourses and from concrete experiences with other countries. The affinities of Icelandic adolescents are split between the islands of the Northern Atlantic, continental Nordic countries, European core countries, and North American countries. If they had to leave Iceland, however, the largest proportion of Icelandic adolescents would want to move to the United States. Girls are more likely to choose the Nordic countries, in particular Denmark, while boys are more likely to choose English-speaking countries with a reputation for economic and military power such as the United States and England. Adolescents are more likely to prefer migrating to Europe rather than North America if they are proud of their Icelandic nationality, live in cohesive communities, have more educated parents, and feel closer to Europe. Adolescents who want to move abroad are in contrast most likely to have North American destinations in mind. Recent geopolitical changes may however shift the attention of Icelandic adolescents eastward towards the European continent.This article has benefited greatly from extensive discussions with Atli Hafthorsson, Brynhildur
Thorarinsdottir, Kjartan Olafsson and Michael S. Gibbons, and from the pioneering scholarship of Professor Thorbjorn Broddason. The data collection was in part made possible by a grant from the University of Akureyri Research Fund.Peer Reviewe
The prognostic effect of known and newly detected type 2 diabetes in patients with acute coronary syndrome.
To access publisher's full text version of this article click on the hyperlink belowBackground: Dysglycemia is a well-established risk factor of coronary artery disease. Less is known of the prognostic effect of dysglycemia in acute coronary syndromes (ACSs). The aim of this study was to evaluate the long-term outcome of patients with ACSs according to glucometabolic categories.
Methods: Patients with ACSs were consecutively included in the study. Among those with no previous history of type 2 diabetes (T2DM) glucose metabolism was evaluated with fasting glucose in plasma, glycated hemoglobin and a standard 2-h oral glucose tolerance test. Patients were classified having normal glucose metabolism, prediabetes, newly detected T2DM (nT2DM) and previously known T2DM (kT2DM). The clinical outcome parameters were death or myocardial infarction and other major adverse cardiac events (MACEs).
Results: A total of 372 ACS patients (male 75.8%, 65.1 years (SD: 11.8)) constituted the study population. The proportion diagnosed with normal glucose metabolism, prediabetes, nT2DM and kT2DM was 20.7%, 46.5%, 6.2% and 26.6%, respectively. The mean follow-up period was 2.9 years. Patients with prediabetes, nT2DM and kT2DM had a hazard ratio of 5.8 (95% confidence interval (CI) 0.8-44.6), 10.9 (95% CI 1.2-98.3) and 14.9 (95% CI 2.0-113.7), respectively, for death/myocardial infarction and 1.4 (95% CI 0.6-3.1), 2.9 (95% CI 1.1-8.0) and 3.3 (95% CI 1.5-7.6), respectively, for a composite of MACEs.
Conclusion: Patients with ACS and nT2DM or kT2DM were at increased risk of death/myocardial infarction and MACE compared with patients with normal glucose metabolism after approximately three years of follow-up.
Keywords: Acute coronary syndrome; prognosis; survival; type 2 diabetes.University of Iceland Research Fund
Landspitali University Hospital Research Fund
Icelandic Society of Cardiology Research Fun
Diagnosis of type 2 diabetes and prediabetes among patients with acute coronary syndromes.
To access publisher's full text version of this article click on the hyperlink belowPreviously undetected dysglycaemia is common among patients with acute coronary syndromes (ACSs). The aim of this study was to identify the most reliable method of diagnosing type 2 diabetes mellitus (T2DM) and prediabetes in ACS patients.Patients admitted to the coronary care unit with ACSs and no previous history of T2DM were consecutively included in the study. Glucose metabolism was measured by glycated haemoglobin (HbA1c), fasting plasma glucose (FPG) and 2-hour plasma glucose (2hPG) with a standard oral glucose tolerance test during hospital admission, and this process was repeated 3 months later. In this study, the diagnosis of T2DM required at least two measurements above the diabetes cut-off point according to current American Diabetes Association and World Health Organization criteria.A total of 250 patients were included in the study. T2DM was diagnosed in 7.2%. The sensitivities for detecting T2DM were 33.3%, 61.1% and 77.8% during admission and 27.8%, 61.1% and 72.2% at follow-up for HbA1c, FPG and 2hPG, respectively. The positive predictive values (PPVs) for diagnosing T2DM were 100%, 91.7% and 51.9% during admission and 71.4%, 91.7% and 65.0% at follow-up for HbA1c, FPG and 2hPG, respectively. The specificities and negative predictive values were high for all methods. By combining all measurements, the sensitivity was 100% and the PPV was 44.2%, while the combination of all HbA1c and FPG measurements provided 88.9% sensitivity and 80.0% PPV.Diagnosis of T2DM can be reliably carried out by repeated measurements of FPG and HbA1c in ACS patients, with limited added value of an oral glucose tolerance test.University of Iceland Research Fund and Landspitali University Hospital Research Fund
Oral glucose tolerance test predicts increased carotid plaque burden in patients with acute coronary syndrome.
Type 2 diabetes and prediabetes are established risk factors for atherosclerosis. The aim of this study was to evaluate the atherosclerotic plaque burden in the carotid arteries of patients with acute coronary syndrome according to their glycemic status.Patients with acute coronary syndrome and no previous history of type 2 diabetes were consecutively included in the study. Glucose metabolism was evaluated with fasting glucose in plasma, HbA1c and a standard two-hour oral glucose tolerance test. Atherosclerotic plaque in the carotid arteries was evaluated with a standardized ultrasound examination where total plaque area was measured and patients classified as having no plaque or a significant plaque formation.A total of 245 acute coronary syndrome patients (male 78%, 64 years (SD: 10.9)) were included. The proportion diagnosed with normal glucose metabolism, prediabetes and type 2 diabetes was 28.6%, 64.1% and 7.3%, respectively. A significant atherosclerotic plaque was found in 48.5%, 66.9% and 72.2% of patients with normal glucose metabolism, prediabetes and type 2 diabetes, respectively. An incremental increase in total plaque area was found from normal glucose metabolism to prediabetes (25.5%) and from normal glucose metabolism to type 2 diabetes (35.9%) (p = 0.04). When adjusted for conventional cardiovascular risk factors the OR of having significant atherosclerotic plaque in the carotid arteries was 2.17 (95% CI 1.15-4.15) for patients with newly diagnosed dysglycemia compared to patients with normal glucose metabolism. When additionally adjusted for the 2-hour plasma glucose after glucose loading (2hPG) the OR attenuated to 1.77 (95% CI 0.83-3.84).Newly detected dysglycemia is an independent predictor of significant atherosclerotic plaque in the carotid arteries with oral glucose tolerance test as a major determinant of carotid plaque burden in this group of individuals with acute coronary syndrome
Pertinent characteristics of patients divided according to their glucose metabolism.
<p>Pertinent characteristics of patients divided according to their glucose metabolism.</p
Carotid plaque burden among patients with IFG, IGT and combination of IFG and IGT.
<p>Carotid plaque burden among patients with IFG, IGT and combination of IFG and IGT.</p
Glucose metabolic derangements and carotid plaque burden.
<p>Glucose metabolic derangements and carotid plaque burden.</p