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Dzidzonu D.K.,University of Oslo | Skrivarhaug T.,University of Oslo | Skrivarhaug T.,Oslo Diabetes Research Center | Joner G.,University of Oslo | Moger T.A.,University of Oslo
Pediatric Diabetes | Year: 2016

Background: Few studies have looked at variation in type 1 diabetes incidence between immigrant groups within a country. Objective: To investigate differences in incidence rates of childhood-onset type 1 diabetes between immigrant groups and ethnic Norwegians, and their contribution to the number of incident cases of type 1 diabetes in Norway. Subjects: The study includes 2221 individuals with newly onset type 1 diabetes diagnosed during 2002–2009 in children of 0–14 yr in Norway registered in the nationwide and population-based Norwegian Childhood Diabetes Registry. Methods: Incident cases were classified in seven groups based on country of maternal birth and three age groups. Statistics Norway provided the corresponding population sizes. Incidence rates were compared by Poisson regression. Results: The overall incidence rate was 34.0 cases per 100,000 person-years (95% CI: 32.6, 35.5). There were large variations in incidence across the immigrant groups (p < 0.001), ranging from 6.8 per 100,000 person-years (95% CI: 1.9–17.5) for South/East Asians to 26.0 cases per 100,000 person-years (95% CI: 11.9–49.3) for sub-Saharan Africans. The differences remained significant after adjusting for age and gender. Conclusions: There are large variations in the rate of incidence of type 1 diabetes across the ethnic groups, and several immigrant groups have significantly lower incidence than ethnic Norwegians. Immigrant groups contributed ca. 5% of the total cases of type 1 diabetes and influence the overall incidence in Norway only to a small extent. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Wisting L.,University of Oslo | Froisland D.H.,Lillehammer University College | Skrivarhaug T.,University of Oslo | Skrivarhaug T.,Oslo Diabetes Research Center | And 3 more authors.
Diabetes Care | Year: 2013

OBJECTIVE-To establish the prevalence of disturbed eating behavior (DEB) and insulin omission among adolescents with type 1 diabetes using intensive insulin treatment in a nationwide population-based study. RESEARCH DESIGN ANDMETHODSdThe Diabetes Eating Problem Survey-Revised (DEPS-R) is a diabetes-specific screening tool for DEB. Clinical data and HbA1c were obtained from the Norwegian Childhood Diabetes Registry. RESULTS-A total of 770 children and adolescents 11-19 years of age with type 1 diabetes completed the DEPS-R. A total of 27.7% of the females and 8.6% of the males scored above the DEPS-R cutoff. Participants scoring above the cutoff had significantly higher HbA1c (9.2% [77 mmol/mol]; SD, 1.6) than participants scoring below the cutoff (8.4% [68 mmol/mol]; SD, 1.3; P<0.001). The prevalence of DEB increased significantly with age and weight, from7.2%in the underweight group to 32.7% in the obese group, and from 8.1% in the youngest age-group (11- 13 years) to 38.1% in the oldest age-group (17-19 years). A total of 31.6% of the participants reported insulin restriction and 6.9% reported insulin omission after overeating. Patients reporting insulin restriction had significantly higher HbA1c (9.0% [75 mmol/mol]; SD, 1.7) than nonrestrictors (8.3% [67 mmol/mol]; SD, 1.2; P < 0.001). CONCLUSIONS-One-fourth of girls with type 1 diabetes scored above the cutoff for DEB and one-third reported skipping their insulin dose entirely at least occasionally after overeating. Both DEB and insulin restriction were associated with poorer metabolic control, which may increase the risk of serious late diabetes complications. © 2013 by the American Diabetes Association.

Gagnum V.,University of Oslo | Gagnum V.,Oslo Diabetes Research Center | Stene L.C.,Oslo Diabetes Research Center | Stene L.C.,Norwegian Institute of Public Health | And 7 more authors.
Diabetologia | Year: 2015

Aims/hypothesis: The aim of this study was to assess the association between all-cause mortality and sex, age at diagnosis and year of diagnosis in Norwegian patients with childhood-onset diabetes. Methods: The study was based on the nationwide, population-based Norwegian Childhood Diabetes Registry, which includes all newly diagnosed cases of childhood-onset diabetes at age 0–14 years in 1973–1982 and 1989–2012 (n = 7,884). Patients were followed until date of death, emigration or 30 September 2013. Results: Among the 7,884 patients, representing 132,420 person-years, 249 (3.2%) died during a mean follow-up of 16.8 (range 0.0–40.7) years. The standardised mortality ratio (SMR) for the total cohort was 3.6 (95% CI 3.1, 4.0), increasing by attained age. Absolute mortality was significantly lower in females than in males (HR 0.50 [95% CI 0.38, 0.65]), although the SMRs were similar. Cox regression analysis showed a significant decrease in mortality of 49% (HR 0.51 [95% CI 0.28, 0.93]) for those diagnosed in 1999–2012 compared with those diagnosed in 1973–1982 (p = 0.03). Conclusions/interpretation: In spite of improved diabetes care, mortality is still three to four times higher in those with childhood-onset diabetes compared with the general population in Norway. However, absolute mortality has declined among children diagnosed most recently (1999–2012) compared with those diagnosed in the earliest period (1973–1982). © 2015, Springer-Verlag Berlin Heidelberg.

Froisland D.H.,Lillehammer University College | Graue M.,University of Bergen | Graue M.,Bergen University College | Markestad T.,University of Bergen | And 6 more authors.
Acta Paediatrica, International Journal of Paediatrics | Year: 2013

Aim To examine health-related quality of life (HRQOL) in children and adolescents with type 1 diabetes on intensive insulin treatment. Methods All children and adolescents with type 1 diabetes above 8 years of age scheduled for follow-up at 21 paediatric departments in Norway, and one of their parents was invited to describe HRQOL by completing DISABKIDS questionnaires. HRQOL was related to sociodemographic factors (i.e. parental economy, education, marital status and to level of physical activity and disease characteristics, obtained from the Norwegian Childhood Diabetes Registry). Results Nine hundred and thirty seven (48%) and one of their parents responded. Mean duration of diabetes was 4.9 years (SD 3.3), 51% were girls, 56% used insulin pumps, and 44% used multiple insulin injections, predominantly of long-acting and rapid insulin analogues. Mean HbA1c was 8.5% (SD 1.3). Lower HRQOL scores were significantly associated with higher HbA1c, being a girl and experience of diabetes ketoacidosis. Mothers scored lower than fathers on total score and most subscales. No significant differences in scores were found between users of an insulin pump and multi-injection treatment. Conclusions Health-related quality of life was related to metabolic control and gender, but not to mode of intensified insulin treatment. © 2013 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd.

Heier M.,University of Oslo | Heier M.,Oslo Diabetes Research Center | Margeirsdottir H.D.,University of Oslo | Margeirsdottir H.D.,Oslo Diabetes Research Center | And 10 more authors.
Diabetes and Vascular Disease Research | Year: 2015

Background: Advanced protein glycation is an important mechanism for the development of late diabetic complications including atherosclerosis. Methylglyoxal-derived hydroimidazolone-1 is the most abundant advanced glycation end product in human plasma. Aim: To investigate the relationship between methylglyoxal-derived hydroimidazolone-1 and early signs of atherosclerosis in children and adolescents with type 1 diabetes and healthy controls. Methods: A total of 314 diabetes patients aged 818 years were compared with 120 healthy controls. Serum methylglyoxalderived hydroimidazolone-1 was measured by immunoassay. Atherosclerosis was evaluated by assessing carotid intimamedia thickness by ultrasound, arterial stiffness by Youngs modulus and inflammation by C-reactive protein. Results: Methylglyoxal-derived hydroimidazolone-1 was significantly increased in the diabetes group compared with controls, 155.3 (standard deviation (SD) = 41.0) versus 143.0 (SD = 35.1) U/mL, ρ = 0.003, as was C-reactive protein, median 0.51 (0.27, 1.83) versus 0.31 (0.19, 0.67) mg/L, ρ < 0.001. There was no significant difference between the groups regarding carotid intima-media thickness or Youngs modulus. Multiple regression analysis showed a significant positive association between methylglyoxal-derived hydroimidazolone-1 and C-reactive protein in the diabetes group. Conclusion: Serum levels of methylglyoxal-derived hydroimidazolone-1 in diabetes patients are increased and associated with low-grade inflammation, but not yet arterial stiffness or wall thickness. This indicates that methylglyoxal-derived hydroimidazolone-1 may be important in the early phase of the accelerated atherosclerotic process in diabetes.

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