Glucose‐lowering drug use in migrants and native Danes with type 2 diabetes: Disparities in combination therapy and drug types DOI Creative Commons
Anders Aasted Isaksen, Annelli Sandbæk, Mette Vinther Skriver

et al.

Diabetes Obesity and Metabolism, Journal Year: 2023, Volume and Issue: 25(11), P. 3307 - 3316

Published: Aug. 7, 2023

To examine disparities in glucose-lowering drug (GLD) usage between migrants and native Danes with type 2 diabetes (T2D).In a nationwide, register-based cross-sectional study of 253 364 individuals prevalent T2D on December 31, 2018, we examined user prevalence during 2019 (i) GLD combination therapies (ii) individual types. Migrants were grouped by origin (Middle East, Europe, Turkey, Former Yugoslavia, Pakistan, Sri Lanka, Somalia, Vietnam), relative risk (RR) versus was computed using robust Poisson regression to adjust for clinical socioeconomic characteristics.In 2019, 34.7% received therapy, lower most migrant groups (RR from 0.78, 95% confidence interval CI 0.71-0.85 [Somalia group] 1.00, 0.97-1.04 [former Yugoslavia group]). Among Danes, the widely used oral metformin (used 62.1%), followed dipeptidyl peptidase-4 inhibitors (13.3%), sodium-glucose cotransporter-2 (11.9%) sulphonylureas (5.2%), higher use any GLD: 0.99, 0.97-1.01 [Europe 1.09, 1.06-1.11 [Sri Lanka Furthermore, 18.7% insulins 13.3% glucagon-like peptide-1 receptor agonists (GLP-1RAs), but less insulins: 0.66, 0.62-0.71 0.94, 0.89-0.99 group]; RR GLP-1RAs: 0.29, 0.22-0.39 0.95, 0.89-1.01 group]).Disparities types therapy evident Danes. more likely GLDs injection-based GLDs, particularly GLP-1RAs, which may contribute complication mortality among this group.

Language: Английский

Guideline-level monitoring, biomarker levels and pharmacological treatment in migrants and native Danes with type 2 diabetes: Population-wide analyses DOI Creative Commons
Anders Aasted Isaksen, Annelli Sandbæk, Mette Vinther Skriver

et al.

PLOS Global Public Health, Journal Year: 2023, Volume and Issue: 3(10), P. e0001277 - e0001277

Published: Oct. 18, 2023

The prevalence of type 2 diabetes (T2D) is higher in migrants compared to native populations many countries, but the evidence on disparities T2D care inconsistent. Therefore, this study aimed examine Denmark. In a cross-sectional, register-based 254,097 individuals with T2D, 11 indicators guideline-level were analysed: a) monitoring: hemoglobin-A1c (HbA1c), low-density lipoprotein cholesterol (LDL-C), screening for diabetic nephropathy, retinopathy, and foot disease, b) biomarker control: HbA1c LDL-C levels, c) pharmacological treatment: glucose-lowering drugs (GLD), lipid-lowering drugs, angiotensin-converting enzyme-inhibitors/angiotensin receptor blockers, antiplatelet therapy. Migrants grouped by countries origin: Middle East, Europe, Turkey, Former Yugoslavia, Pakistan, Sri Lanka, Somalia, Vietnam. all migrant groups except Europe-group, was more prevalent than Danes (crude relative risk (RR) from 0.62 [0.61-0.64] (Europe) 3.98 [3.82-4.14] (Sri Lanka)). eight indicators, non-fulfillment common (>25% among Danes). Apart monitoring Lanka-group, at similar or across control (RR 0.64 [0.51-0.80] (HbA1c monitoring, Lanka) 1.78 [1.67-1.90] (LDL-C control, Somalia)), while no overall pattern observed treatment 0.61 [0.46-0.80] (GLD, 1.67 [1.34-2.09] Somalia)). Care poorest who had increased eleven highest nine. Adjusted risks elevated some groups, particularly (fully-adjusted RR 0.84 [0.75-0.94] Vietnam) 1.44 [1.35-1.54] most prevalent, inferior Danes. Somalia received overall, exceedingly high lipid levels.

Language: Английский

Citations

3
Nudging a Nation — The Danish NUDGE Trial Concept DOI
Niklas Dyrby Johansen, Muthiah Vaduganathan, Ankeet S. Bhatt

et al.

NEJM Evidence, Journal Year: 2023, Volume and Issue: 3(1)

Published: Dec. 26, 2023

Danish NUDGE Trial ConceptRandomized encouragement trials randomize to an opportunity receive treatment instead of the treatment. Here, Johansen and colleagues combine randomized with several advantages inherent in health system.

Language: Английский

Citations

3
The impact of colectomy and chemotherapy on risk of type 2 diabetes onset in patients with colorectal cancer: Nationwide cohort study in Denmark DOI Open Access

C Krag,

Maria S. Svane, Sten Madsbad

et al.

Published: March 13, 2024

Comorbidity with type 2 diabetes (T2D) results in worsening of cancer-specific and overall prognosis colorectal cancer (CRC) patients. The treatment CRC per se may be diabetogenic. We assessed the impact different types surgical resections oncological on risk T2D development patients.We developed a population-based cohort study including all Danish patients, who had undergone surgery between 2001-2018. Using nationwide register data, we identified followed patients from date until new-onset T2D, death or end follow-up.In total, 46,373 were included divided into six groups according to resection: 10,566 Right-No-Chemo (23%), 4,645 Right-Chemo (10%), 10,151 Left-No-Chemo (22%), 5,257 Left-Chemo (11%), 9,618 Rectal-No-Chemo (21%) 6,136 Rectal-Chemo (13%). During 245,466 person-years follow-up 2,556 T2D. incidence rate (IR) was highest group 11.3 (95%CI: 10.4-12.2) 1,000 lowest 9.6 8.8-10.4). Between-group unadjusted hazard ratio (HR) developing similar non-significant. In adjusted analysis, associated lower (HR 0.86 [95%CI 0.75-0.98]) compared Right-No-Chemo.For groups, an increased level BMI resulted nearly twofold T2DThis suggests postoperative screening should prioritized survivors overweight/obesity regardless applied.The Novo Nordisk Foundation ( NNF17SA0031406); TrygFonden (101390; 20045; 125132).

Language: Английский

Citations

0
Longitudinal HbA1c patterns before the first treatment of diabetes in routine clinical practice: A latent class trajectory analysis DOI
Sia Kromann Nicolaisen, Saskia le Cessie, Reimar W. Thomsen

et al.

Diabetes Research and Clinical Practice, Journal Year: 2024, Volume and Issue: 212, P. 111722 - 111722

Published: May 28, 2024

Language: Английский

Citations

0
The impact of surgery and oncological treatment on risk of type 2 diabetes onset in patients with colorectal cancer: nationwide cohort study in Denmark DOI Creative Commons

C Krag,

Maria S. Svane, Sten Madsbad

et al.

eLife, Journal Year: 2024, Volume and Issue: 12

Published: June 3, 2024

Background: Comorbidity with type 2 diabetes (T2D) results in worsening of cancer-specific and overall prognosis colorectal cancer (CRC) patients. The treatment CRC per se may be diabetogenic. We assessed the impact different types surgical resections oncological on risk T2D development Methods: developed a population-based cohort study including all Danish patients, who had undergone surgery between 2001 2018. Using nationwide register data, we identified followed patients from date until new onset T2D, death, or end follow-up. Results: In total, 46,373 were included divided into six groups according to resection: 10,566 Right-No-Chemo (23%), 4645 Right-Chemo (10%), 10,151 Left-No-Chemo (22%), 5257 Left-Chemo (11%), 9618 Rectal-No-Chemo (21%), 6136 Rectal-Chemo (13%). During 245,466 person-years follow-up, 2556 T2D. incidence rate (IR) was highest group 11.3 (95% CI: 10.4–12.2) 1000 lowest 9.6 8.8–10.4). Between-group unadjusted hazard ratio (HR) developing similar non-significant. adjusted analysis, associated lower (HR 0.86 [95% CI 0.75–0.98]) compared Right-No-Chemo. For groups, an increased level body mass index (BMI) resulted nearly twofold Conclusions: This suggests that postoperative screening should prioritised survivors overweight/obesity regardless applied. Funding: Novo Nordisk Foundation ( NNF17SA0031406) ; TrygFonden (101390; 20045; 125132).

Language: Английский

Citations

0
Rational Pharmacotherapy in Type 2 Diabetes: Danish Data From 2002 to 2020 on Mortality, Diabetes- Related Outcomes, Adverse Events, and Medication Expenses DOI
Karl Sebastian Johansson, Espen Jimenez‐Solem, Tonny Studsgaard Petersen

et al.

Diabetes Care, Journal Year: 2024, Volume and Issue: 47(9), P. 1656 - 1663

Published: July 12, 2024

OBJECTIVE Developments in pharmacotherapy and management of type 2 diabetes may have shifted the balance treatment benefits versus harms costs over past decades. This study aimed to describe trends this balance. RESEARCH DESIGN AND METHODS We followed Danish population with between 2002 2020, analyzing their medication use relation (such as mortality diabetes-related outcomes), adverse events, costs. Using multivariate analyses, we adjusted for potential confounders, including age, sex, socioeconomic status. RESULTS The included 461,805 individuals. From median age increased from 66 68 years, mean number comorbidities 5.2 8.8. overall incidence cardiovascular, renal, other important clinical outcomes decreased. Similarly, rate some such gastric bleeding, hypoglycemia, falls declined, whereas electrolyte imbalances ketoacidosis increased. average per-patient cost was reduced by 8%, but total expenses 148% due an expanding size, lowered most cardiovascular medications, increasing glucose-lowering drugs. CONCLUSIONS Advancements led risk both harms, while maintaining relatively stable expenses. Although these are multifactorial, they suggest more rational pharmacotherapy. Still, certain along underscores need ongoing vigilance risk-benefit analysis.

Language: Английский

Citations

0
Machine Learning–Driven Prediction of Comorbidities and Mortality in Adults With Type 1 Diabetes DOI
J. S. Andersen, Carsten Wridt Stoltenberg, Morten Hasselstrøm Jensen

et al.

Journal of Diabetes Science and Technology, Journal Year: 2024, Volume and Issue: unknown

Published: Aug. 2, 2024

Comorbidities such as cardiovascular disease (CVD) and diabetic kidney (DKD) are major burdens of type 1 diabetes (T1D). Predicting people at high risk developing comorbidities would enable early intervention. This study aimed to develop models incorporating socioeconomic status (SES) predict CVD, DKD, mortality in adults with T1D improve identification comorbidities.

Language: Английский

Citations

0
Causes of Excess Mortality in Diabetes Patients Without Coronary Artery Disease: A Cohort Study Revealing Endocrinologic Contributions DOI Creative Commons
Guilian Birindwa, Michael Mæng, Pernille Gro Thrane

et al.

Clinical Epidemiology, Journal Year: 2024, Volume and Issue: Volume 16, P. 571 - 585

Published: Sept. 1, 2024

Diabetes mellitus (DM) patients without coronary artery disease (CAD) have a higher all-cause mortality rate than with neither DM nor CAD. We examined cause-specific death of and

Language: Английский

Citations

0
Attributable one‐year healthcare cost of incident type 2 diabetes: A population‐wide difference‐in‐differences study in Denmark DOI Creative Commons
Eskild Klausen Fredslund, Annelli Sandbæk, Thim Prætorius

et al.

Diabetic Medicine, Journal Year: 2024, Volume and Issue: unknown

Published: Oct. 16, 2024

Abstract Aim The aim of this study is to estimate the causally attributable one‐year healthcare costs for individuals getting a type 2 diabetes diagnosis compared matched sample and show incurred medication in primary secondary healthcare. Methods Causal estimation using difference‐in‐differences design health care diabetes. Danish registry data consisting entire population years 2016–2019. Newly diagnosed with 2018 were identified validated method. Sociodemographic historical used identify control group. Individuals followed two before one year after date using. Three cost components analysed: costs. Results A total 18,133 successfully 1:1 was EUR 1316. main component hospital (EUR 1004) 167). incident Denmark approx. 24 million. Conclusions majority first at level by medication. Our yearly per newly considerably lower than estimates from US Australia.

Language: Английский

Citations

0
Diabetes distress and depression in type 2 diabetes. A cross‐sectional study in 18,000 individuals in the Central Denmark region DOI Creative Commons
Else‐Marie Dalsgaard, Susanne Boel Graversen, Lasse Bjerg

et al.

Diabetic Medicine, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 12, 2024

Abstract Aims Type 2 diabetes is linked to psychological distress and a doubled risk of depression. This study aims characterize individuals with type experiencing and/or depression in relation lifestyle metabolic outcomes. Methods A population‐based survey 2020 targeted (aged 18–75 years) the Central Denmark Region. cross‐sectional assessed (using Problem‐Area‐in‐Diabetes‐scale) (via hospital diagnosis prescribed medication) as exposures. Logistic regression, adjusting for potential confounders, compared exposed non‐exposed groups on habits, factors medication usage related cardio‐metabolic risks. Results Of 18,222 respondents (46% response rate), 11% had depression, 14% 4% both. Compared those neither condition, were more often smokers (OR: 2.0, 95% CI: 1.8; 2.3) sedentary leisure time 2.2). Diabetes was associated elevated HbA1c 1.8, 1.5; 2.0) treatment insulin 1.6; 2.0). Half displayed stable blood glucose levels. Those both conditions higher behaviour 2.7, 2.3; 3.2), clinical insomnia 6.5, 5.5; 7.7) low self‐rated health 7.5, 6.3; 9.0) than either condition isolation. Conclusions emphasizes importance recognizing distinct features diabetes. Tailored care strategies comorbid mental issues are crucial comprehensive management.

Language: Английский

Citations

0