FinDM database on diabetes in Finland

This paper describes the collection of database of the Diabetes in Finland (FinDM) project which aims to identify all potential persons with diabetes from national registers in Finland between 1964 and 2017. Further, it lists the definitions used in the research of diabetes and its complications in the project

Lisäsairaudet voivat moninkertaistaa tyypin 2 diabetespotilaan terveydenhuollon kustannukset

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Increased cancer mortality in diabetic people treated with insulin: a register-based follow-up study

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Mitä suomalainen tyypin 2 diabeteksen ehkäisytutkimus DPS on opettanut?

Vertaisarvioitu.Suomalainen diabeteksen ehkäisytutkimus (Diabetes Prevention Study, DPS) loi näyttöön pohjautuvan perustan tyypin 2 diabeteksen ehkäisylle elintapaohjauksella Suomessa ja maailmanlaajuisesti. DPS-tutkimuksen tehostettu elintapaohjaus, jonka tavoitteena olivat suositusten mukainen ruokavalio, fyysinen aktiivisuus ja painon väheneminen, vaikutti suotuisasti diabetekseen liittyviin aineenvaihduntahäiriöihin ja pienensi diabeteksen ilmaantuvuutta 58 % henkilöillä, joiden glukoosinsieto oli lähtötilanteessa heikentynyt. Elintapaohjaus tehosi myös perinnöllisen diabetesalttiuden yhteydessä. Jatkoseurannassa elintapaohjauksen vaikutus diabeteksen ilmaantuvuuteen säilyi ainakin 13 vuoden ajan, vaikka elintapaohjaus lopetettiin keskimäärin neljän vuoden jälkeen. DPS-tutkimuksen aineistoa on tähän mennessä analysoitu ja raportoitu sekä sen tuloksia hyödynnetty monipuolisesti, ja osallistujien seuranta jatkuu rekisteritutkimuksena. Näin saamme tietoa myös diabeteksen lisäsairauksien kehittymisestä.Peer reviewe

Mitä suomalainen tyypin 2 diabeteksen ehkäisytutkimus DPS on opettanut?

Vertaisarvioitu.Suomalainen diabeteksen ehkäisytutkimus (Diabetes Prevention Study, DPS) loi näyttöön pohjautuvan perustan tyypin 2 diabeteksen ehkäisylle elintapaohjauksella Suomessa ja maailmanlaajuisesti. DPS-tutkimuksen tehostettu elintapaohjaus, jonka tavoitteena olivat suositusten mukainen ruokavalio, fyysinen aktiivisuus ja painon väheneminen, vaikutti suotuisasti diabetekseen liittyviin aineenvaihduntahäiriöihin ja pienensi diabeteksen ilmaantuvuutta 58 % henkilöillä, joiden glukoosinsieto oli lähtötilanteessa heikentynyt. Elintapaohjaus tehosi myös perinnöllisen diabetesalttiuden yhteydessä. Jatkoseurannassa elintapaohjauksen vaikutus diabeteksen ilmaantuvuuteen säilyi ainakin 13 vuoden ajan, vaikka elintapaohjaus lopetettiin keskimäärin neljän vuoden jälkeen. DPS-tutkimuksen aineistoa on tähän mennessä analysoitu ja raportoitu sekä sen tuloksia hyödynnetty monipuolisesti, ja osallistujien seuranta jatkuu rekisteritutkimuksena. Näin saamme tietoa myös diabeteksen lisäsairauksien kehittymisestä.Peer reviewe

Prognosis of ovarian cancer in women with type 2 diabetes using metformin and other forms of antidiabetic medication or statins : a retrospective cohort study

Abstract Background Ovarian cancer is one of the most lethal cancers and women with type 2 diabetes (T2D) have even poorer survival from it. We assessed the prognosis of ovarian cancer in women with type 2 diabetes treated with metformin, other forms of antidiabetic medication, or statins. Methods Study cohort consisted of women with T2D diagnosed with ovarian cancer in Finland 1998–2011. They were identified from a nationwide diabetes database (FinDM), being linked to several national registers. Patients were grouped according to their medication in the three years preceding ovarian cancer diagnosis. The Aalen–Johansen estimator was used to describe cumulative mortality from ovarian cancer and from other causes in different medication groups. Mortality rates were analysed by Cox models, and adjusted hazard ratios (HR) with 95% confidence intervals (95% CIs) were estimated in relation to the use of different forms of medication. Main outcome measures were death from ovarian cancer and death from other causes. Results During the accrual period 421 newly diagnosed ovarian cancers were identified in the FinDM database. No evidence was found for any differences in mortality from ovarian cancer or other causes between different antidiabetic medication groups. Pre-diagnostic use of statins was observed to be associated with decreased mortality from ovarian cancer compared with no such use (HR 0.72, 95% CI 0.56–0.93). Conclusions Our findings are inconclusive as regards the association between metformin and ovarian cancer survival. However, some evidence was found for improved prognosis of ovarian cancer with pre-diagnostic statin use, requiring cautious interpretation, though

Association of ADIPOR2 gene variants with cardiovascular disease and type 2 diabetes risk in individuals with impaired glucose tolerance: the Finnish Diabetes Prevention Study

<p>Abstract</p> <p>Background</p> <p>Adiponectin is an adipokine with insulin-sensitising and anti-atherogenic effects. Two receptors for adiponectin, ADIPOR1 and ADIPOR2, have been characterized that mediate effects of adiponectin in various tissues. We examined whether genetic variation in <it>ADIPOR2 </it>predicts the development of cardiovascular disease (CVD) and/or Type 2 Diabetes (T2DM) in individuals with impaired glucose tolerance (IGT) participating the Finnish Diabetes Prevention Study (DPS).</p> <p>Methods</p> <p>CVD morbidity and mortality data were collected during a median follow-up of 10.2 years (range 1-13 years) and conversion from IGT to T2DM was assessed during a median follow-up of 7 years (range 1-11 years). Altogether eight SNPs in the <it>ADIPOR2 </it>locus were genotyped in 484 participants of the DPS. Moreover, the same SNPs were genotyped and the mRNA expression levels of <it>ADIPOR2 </it>were determined in peripheral blood mononuclear cells and subcutaneous adipose tissue samples derived from 56 individuals participating in the Genobin study.</p> <p>Results</p> <p>In the DPS population, four SNPs (rs10848554, rs11061937, rs1058322, rs16928751) were associated with CVD risk, and two remained significant (p = 0.014 for rs11061937 and p = 0.020 for rs1058322) when all four were included in the same multi-SNP model. Furthermore, the individuals homozygous for the rare minor alleles of rs11061946 and rs11061973 had increased risk of converting from IGT to T2DM. Allele-specific differences in the mRNA expression levels for the rs1058322 variant were seen in peripheral blood mononuclear cells derived from participants of the Genobin study.</p> <p>Conclusions</p> <p>Our results suggest that SNPs in the <it>ADIPOR2 </it>may modify the risk of CVD in individuals with IGT, possibly through alterations in the mRNA expression levels. In addition an independent genetic signal in <it>ADIPOR2 </it>locus may have an impact on the risk of developing T2DM in individuals with IGT.</p> <p>Trial registration number</p> <p>ClinicalTrials.gov <a href="http://www.clinicaltrials.gov/ct2/show/NCT00981877">NCT00518167</a></p

Ten-Year Mortality and Cardiovascular Morbidity in the Finnish Diabetes Prevention Study—Secondary Analysis of the Randomized Trial

The Finnish Diabetes Prevention Study (DPS) was a randomized controlled trial, which showed that it is possible to prevent type 2 diabetes by lifestyle changes. The aim of the present study was to examine whether the lifestyle intervention had an effect on the ten-year mortality and cardiovascular morbidity in the DPS participants originally randomized either into an intervention or control group. Furthermore, we compared these results with a population-based cohort comprising individuals of varying glucose tolerance states.Middle-aged, overweight people with IGT (n = 522) were randomized into intensive intervention (including physical activity, weight reduction and dietary counseling), or control "mini-intervention" group. Median length of the intervention period was 4 years and the mean follow-up was 10.6 years. The population-based reference study cohort included 1881 individuals (1570 with normal glucose tolerance, 183 with IGT, 59 with screen-detected type 2 diabetes, 69 with previously known type 2 diabetes) with the mean follow-up of 13.8 years. Mortality and cardiovascular morbidity data were collected from the national Hospital Discharge Register and Causes of Death Register. Among the DPS participants who consented for register linkage (n = 505), total mortality (2.2 vs. 3.8 per 1000 person years, hazard ratio HR = 0.57, 95% CI 0.21-1.58) and cardiovascular morbidity (22.9 vs. 22.0 per 1000 person years, HR = 1.04, 95% CI 0.72-1.51) did not differ significantly between the intervention and control groups. Compared with the population-based cohort with impaired glucose tolerance, adjusted HRs were 0.21 (95% CI 0.09-0.52) and 0.39 (95% CI 0.20-0.79) for total mortality, and 0.89 (95% CI 0.62-1.27) and 0.87 (0.60-1.27) for cardiovascular morbidity in the intervention and control groups of the DPS, respectively. The risk of death in DPS combined cohort was markedly lower than in FINRISK IGT cohort (adjusted HR 0.30, 95% CI 0.17-0.54), but there was no significant difference in the risk of CVD (adjusted HR 0.88, 95% CI 0.64-1.21).Lifestyle intervention among persons with IGT did not decrease cardiovascular morbidity during the first 10 years of follow-up. However, the statistical power may not be sufficient to detect small differences between the intervention and control groups. Low total mortality among participants of the DPS compared with individuals with IGT in the general population could be ascribed to a lower cardiovascular risk profile at baseline and regular follow-up.ClinicalTrials.gov NCT00518167

The Association between HbA1c, Fasting Glucose, 1-Hour Glucose and 2-Hour Glucose during an Oral Glucose Tolerance Test and Cardiovascular Disease in Individuals with Elevated Risk for Diabetes

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