Increasing body mass index at diagnosis of diabetes in young adult people during 1983-1999 in the Diabetes Incidence Study in Sweden (DISS).

Objective. To study trends in body mass index (BMI) at diagnosis of diabetes in all young Swedish adults in the age range of 15-34 years registered in a nation-based registry. Design. The BMI was assessed at diagnosis in diabetic patients 15-34 years of age at diagnosis, for a period of 17 years (1983-1999). Islet cell antibodies (ICA) were measured during three periods (1987-1988, 1992-1993 and 1998-1999). Setting. A nationwide study (Diabetes Incidence Study in Sweden). Subjects. A total of 4727 type 1 and 1083 type 2 diabetic patients. Main outcome measures. Incidence-year specific BMI adjusted for age, gender and time of diagnosis (month). Results. Body mass index at diagnosis increased significantly both in type 1 (21.4 ± 3.6 to 22.5 ± 4.0; P < 0.0001) and in type 2 (27.4 ± 6.8 to 32.0 ± 6.0; P < 0.0001) diabetic patients, also when adjusted for age, gender and month of diagnosis. A similar significant increase in BMI was found in type 1 diabetic patients and in type 2 diabetic patients in the periods 1987-1988, 1992-1993 and 1998-1999; years when ICA were assessed and considered in the classification of diabetes. Despite this increase in BMI, there was no increase in the incidence of diabetes in young-adult people in Sweden. Conclusion. Body mass index at diagnosis of diabetes in subjects 15-34 years of age has substantially increased during 1983-1999 in Sweden when adjusted for age, gender and month of diagnosis

Diabetic control in community care. The use of clinical evaluation and hemoglobin A1

Diabetic control was evaluated in 50 consecutive patients attending a community care centre, either by clinical criteria or by determination of glycosylated hemoglobin (HbA1). Two methods used for the determination of HbA1 were found to give similar results, namely ion exchange chromatography and agar gel electrophoresis. On a group basis, good correlation was observed between HbA1 samples analysed prior to and following the elimination of the labile HbA1 fraction. When comparing three treatment modes (diet alone, hypoglycemic agents or insulin), no significant differences in HbA1 levels were noted. Patients considered to have satisfactory and poor control had significantly higher HbA1 levels than those considered to have good control, while no differences were seen between those considered to have satisfactory or poor control. It is concluded that the methods described for the determination of HbA1 yield similar results. Clinical evaluation of diabetic control is reliable in patients classified to have good or poor control. However, in many patients who are considered to have satisfactory control, regular determinations of HbA1 provide valuable additional information

Improvement of peripheral nerve function after institution of insulin treatment in diabetes mellitus. A case-control study

The influence of improved diabetic control on peripheral nerve function was studied before and 3-4 months after institution of insulin treatment in 22 diabetics unsatisfactorily controlled by oral hypoglycemic agents. After institution of insulin treatment, diabetic control was improved as demonstrated by decreasing levels of HbA1. There was an overall tendency towards improvement of motor and sensory conduction velocities, however significant only in the upper extremities. There was a tendency towards improved temperature sensitivity in the legs, while no changes occurred in the hands and face. The sensation for vibration did not change. It is concluded that improved diabetic control, even in elderly patients with long-standing diabetes, is followed by neurophysiological signs of improved peripheral nerve function

Occupation and survival: a 25-year follow-up study of an aging population

OBJECTIVE: In this retrospective study of an elderly population cohort living in a defined Swedish rural area, the relationship between occupation and survival as a measure of objective health was investigated. The cohort has been followed for 25 years. METHOD: On the basis of the baseline socioeconomic interview from assessments performed when the participants were 67 years of age, an index of active participation in daily occupation was devised. The index was used to investigate the covariation between generic everyday occupation and long-time survival. RESULTS: For the female participants, Kaplan-Meier curves demonstrated differences in survival between the "less active" and "more active," and Cox regression survival analyses resulted in a significant covariance between occupation and survival. For the male participants, no such differences were found. CONCLUSION: The significant results for the women implied support for the core assumption of occupational therapy that a relationship exists between occupation and health. The lack of differences in survival among more active and less active men demonstrates the complexity of studying occupation

Can social class differentials in hypertension be explained by the general susceptibility hypothesis?

In a population-based, cross-sectional study of 310 treated hypertensives (HT) and 288 matched normotensive controls (NT), social and biological variables were investigated. HT comprised a higher proportion of individuals in lower socioeconomic strata (Phypertension social class obesity glucose insulin