Lifetime risk and years lost to type 1 and type 2 diabetes in Denmark, 1996–2016

Introduction Lifetime risk and lifetime lost to diabetes are measures of current diabetes burden in a population. We aimed at quantifying these measures in the Danish population.Research design and methods We modeled incidence and mortality of type 1 diabetes (T1D) and type 2 diabetes (T2D) and non-diabetes mortality based on complete follow-up of the entire population of Denmark in 1996–2016. A multistate model with these transition rates was used to assess the lifetime risk of diabetes, as well as the difference in expected lifetime between persons with type 1 and T2D and persons without.Results In 2016, the lifetime risk of T1D was 1.1% and that for T2D 24%, the latter a 50% increase from 1996. For 50-year-old persons, the lifetime lost was 6.6 years for T1D and 4.8 years for T2D. These figures have been declining over the study period.At 2016, the total foreseeable lives lost in Denmark among patients with T1D were 182 000 years, and those among patients with T2D were 766 000 years, corresponding to 6.6 and 3.0 years per person, respectively.Conclusion At the individual level, improvements in the disease burden for both T1D and T2D have occurred. At the population level, the increasing number of patients with T2D has contributed to a large increase in the total loss of lifetime

Birth weight and risk of adiposity among adult Inuit in Greenland.

OBJECTIVE:The Inuit population in Greenland has undergone rapid socioeconomic and nutritional changes simultaneously with an increasing prevalence of obesity. Therefore, the objective was to examine fetal programming as part of the aetiology of obesity among Inuit in Greenland by investigating the association between birth weight and measures of body composition and fat distribution in adulthood. METHODS:The study was based on cross-sectional data from a total of 1,473 adults aged 18-61 years in two population-based surveys conducted in Greenland between 1999-2001 and 2005-2010. Information on birth weight was collected from birth records. Adiposity was assessed by anthropometry, fat mass index (FMI), fat-free mass index (FFMI), and visceral (VAT) and subcutaneous adipose tissue (SAT) estimated by ultrasound. The associations to birth weight were analyzed using linear regression models and quadratic splines. Analyses were stratified by sex, and adjusted for age, birthplace, ancestry and family history of obesity. RESULTS:Spline analyses showed linear relations between birth weight and adult adiposity. In multiple regression analyses, birth weight was positively associated with BMI, waist circumference, FMI, FFMI and SAT with generally weaker associations among women compared to men. Birth weight was only associated with VAT after additional adjustment for waist circumference and appeared to be specific and inverse for men only. CONCLUSIONS:Higher birth weight among Inuit was associated with adiposity in adulthood. More studies are needed to explore a potential inverse association between birth size and VAT

Validation of cardiovascular diagnoses in the Greenlandic Hospital Discharge Register for epidemiological use

Cardiovascular disease (CVD) is one of the leading causes of death worldwide. In Greenland, valid estimates of prevalence and incidence of CVD do not exist and can only be calculated if diagnoses of CVD in the Greenlandic Hospital Discharge Register (GHDR) are correct. Diagnoses of CVD in GHDR have not previously been validated specifically. The objective of the study was to validate diagnoses of CVD in GHDR. The study was conducted as a validation study with primary investigator comparing information in GHDR with information in medical records. Diagnoses in GHDR were considered correct and thus valid if they matched the diagnoses or the medical information in the medical records. A total of 432 online accessible medical records with a cardiovascular diagnosis according to GHDR from Queen Ingrid’s Hospital from 2001 to 2013 (n=291) and from local health care centres from 2007 to 2013 (n=141) were reviewed. Ninety-nine and ninety-two percent of discharge diagnosis in GHDR from Queen Ingrid’s Hospital and local health care centres were correct in comparison with diagnoses in the medical record indicating valid registration practice. The correctness of cardiovascular diagnoses in GHDR was considered high in terms of acceptable agreement between medical records and diagnoses in GHDR. Cardiovascular diagnoses are valid for epidemiological use

Linear associations between birth weight and measures of adult adiposity.

<p>Estimates for men (black) and women (grey) with 95% CI. • Model 1: Unadjusted. ▴ Model 2: Adjusted for age, birthplace, ancestry and family history of obesity. ▪ Model 3: Adjusted for as model 2 incl. waist circumference.</p

Associations between birth weight and measures of adiposity stratified by sex.

a<p>Model 1. Unadjusted model.</p>b<p>Model 2. Adjusted for age, birthplace, ancestry and family history of obesity.</p>c<p>Model 3. Adjusted for age, birthplace, ancestry, family history of obesity and waist circumference (left column).</p>d<p>Model 3. Adjusted for age, birthplace, ancestry, family history of obesity and birth weight (right column).</p><p>Associations between birth weight and measures of adiposity stratified by sex.</p

Characteristics of the study population (n = 1473).

a<p>Mean ± SD (all such values).</p>b<p>n (%) (all such values).</p><p>Characteristics of the study population (n = 1473).</p

Splines showing the relations between birth weight and measures of adult adiposity for women.

<p>Quadratic splines of the relation between birth weight and (a) body mass index (BMI), (b) waist circumference, (c) fat mass index (FMI), (d) fat-free mass index (FFMI), (e) visceral adipose tissue (VAT) and (f) subcutaneous adipose tissue (SAT). The thick lines represent the relations predicted for a person aged 33, being full Inuit, born in a town, and reported family history of obesity. The full thin lines show the 95% CI and dotted lines show the 95% prediction interval.</p

Splines showing the relations between birth weight and measure of adult adiposity for men.

<p>Quadratic splines of the relation between birth weight and (a) body mass index (BMI), (b) waist circumference, (c) fat mass index (FMI), (d) fat-free mass index (FFMI), (e) visceral adipose tissue (VAT) and (f) subcutaneous adipose tissue (SAT). The thick lines represent the relations are predicted for a person aged 33, being full Inuit, born in a town, and reported family history of obesity. The full thin lines show the 95% CI and dotted lines show the 95% prediction interval.</p