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Jansson, Stefan P. O.ORCID iD iconorcid.org/0000-0001-6864-4679
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Publications (10 of 54) Show all publications
Lind, A., Cao, Y., Hesser, H., Hårdstedt, M., Jansson, S. P. O., Lernmark, Å., . . . Jendle, J. (2024). Anxiety, depression and quality of life in relation to SARS-CoV-2 antibodies in individuals living with diabetes during the second wave of COVID-19. Diabetes epidemiology and management, 13, Article ID 100194.
Open this publication in new window or tab >>Anxiety, depression and quality of life in relation to SARS-CoV-2 antibodies in individuals living with diabetes during the second wave of COVID-19
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2024 (English)In: Diabetes epidemiology and management, ISSN 2666-9706, Vol. 13, article id 100194Article in journal (Refereed) Published
Abstract [en]

Aims: The objective was to compare anxiety, depression, and quality of life (QoL) in individuals living with type 1 (T1D) and type 2 (T2D) diabetes with matched controls during the second wave of the COVID-19 pandemic.

Methods: Via randomization, individuals living with diabetes T1D (n = 203) and T2D (n = 413), were identified during February-July 2021 through health-care registers. Population controls (n = 282) were matched for age, gender, and residential area. Questionnaires included self-assessment of anxiety, depression, QoL, and demographics in relation to SARS-CoV-2 exposure. Blood was collected through home-capillary sampling, and SARS-CoV-2 Nucleocapsid (NCP) and Spike antibodies (SC2_S1) were determined by multiplex Antibody Detection by Agglutination-PCR (ADAP) assays.

Results: Younger age and health issues were related to anxiety, depression, and QoL, with no differences between the study groups. Female gender was associated with anxiety, while obesity was associated with lower QoL. The SARS-CoV-2 NCP seroprevalence was higher in T1D (8.9 %) compared to T2D (3.9 %) and controls (4.0 %), while the SARS-CoV-2 SC2_S1 seroprevalence was higher for controls (25.5 %) compared to T1D (16.8 %) and T2D (14.0 %).

Conclusions: A higher SARS-CoV-2 infection rate in T1D may be explained by younger age and higher employment rate, and the associated increased risk for viral exposure.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Diabetes, SARS-CoV-2, COVID-19, Anxiety, Depression, Quality of life, Virus antibodies
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-111559 (URN)10.1016/j.deman.2023.100194 (DOI)001154927400001 ()2-s2.0-85182889973 (Scopus ID)
Funder
Swedish Foundation for Strategic Research, IRC15-0067
Note

This work was supported by NIH SBIR 2R44DK110005-02, Strategic Research Area Exodiab Dnr 2009-1039, and the Swedish Foundation for Strategic Research Dnr IRC15-0067.

Available from: 2024-02-14 Created: 2024-02-14 Last updated: 2024-02-14Bibliographically approved
Imhagen, A., Karlsson, J., Jansson, S. P. O. & Anderzen-Carlsson, A. (2023). A lifelong struggle for a lighter tomorrow: A qualitative study on experiences of obesity in primary healthcare patients. Journal of Clinical Nursing, 32(5-6), 834-846
Open this publication in new window or tab >>A lifelong struggle for a lighter tomorrow: A qualitative study on experiences of obesity in primary healthcare patients
2023 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 32, no 5-6, p. 834-846Article in journal (Refereed) Published
Abstract [en]

AIM: To describe experiences of living with obesity before the start of a group-based lifestyle intervention.

BACKGROUND: Obesity is a chronic disease that affects a person's physical and psychological health. Increased knowledge of experiences of living with obesity is required.

DESIGN: A qualitative study with a descriptive design.

METHODS: Semi-structured individual interviews with 17 participants living with obesity (Body Mass Index 32-49) were conducted between October and November 2019. The interviews were analysed using qualitative content analysis. The COREQ checklist was followed.

RESULTS: The analysis resulted in one main theme: Struggling for a lighter tomorrow and three subthemes: Suffering, Resilience and Need for support in making changes. For the majority of the participants, living with obesity was a lifelong struggle involving suffering on different levels. Yet despite this, the participants had not given up and hoped for a better life. They showed a degree of resilience and motivation, and a perceived ability to achieve lifestyle changes. However, there was a pronounced need for support to help them achieve this.

CONCLUSION: Living with obesity is complex and carries a risk of medical complications as well as psychosocial suffering. Healthy lifestyle habits to achieve better health and to lose weight should be encouraged, taking patient resources into account. Patients also need help in handling weight stigmatisation, and both healthcare professionals and society must engage with this.

RELEVANCE TO CLINICAL PRACTICE: Obesity is a chronic disease, and patients need ongoing support. Therefore, care for patients with obesity in primary health care must be further developed. Patient resources and strengths have to be acknowledged and encouraged in the process of helping them adopt healthy lifestyle habits. The findings of this study can contribute to ending weight stigmatisation by increasing the knowledge of living with obesity.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
Experiences, lifestyle, nursing, obesity, primary health care, qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:oru:diva-99525 (URN)10.1111/jocn.16379 (DOI)000804990000001 ()35655375 (PubMedID)2-s2.0-85131172733 (Scopus ID)
Note

Funding agency:

University Health Care Research Center, Region Örebro County, Örebro, Sweden

Available from: 2022-06-15 Created: 2022-06-15 Last updated: 2024-01-02Bibliographically approved
Fadl, H., Saeedi, M., Magnuson, A., Patil, S., Simmons, D., Schwarcz, E., . . . Montgomery, S. (2023). Changing diagnostic criteria for gestational diabetes (CDC4G) in Sweden: a stepped wedge cluster randomised controlled trial. In: : . Paper presented at 55th DPSG annual meeting 2023, Poznan, Polen, 7-10 September, 2023.. (1)
Open this publication in new window or tab >>Changing diagnostic criteria for gestational diabetes (CDC4G) in Sweden: a stepped wedge cluster randomised controlled trial
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2023 (English)Conference paper, Oral presentation only (Other academic)
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-109825 (URN)
Conference
55th DPSG annual meeting 2023, Poznan, Polen, 7-10 September, 2023.
Available from: 2023-11-22 Created: 2023-11-22 Last updated: 2024-01-02Bibliographically approved
Rådholm, K., Af Geijerstam, P., Woodward, M., Chalmers, J., Hellgren, M., Jansson, S. P. O. & Rolandsson, O. (2023). Dog ownership, glycaemic control and all-cause death in patients with newly diagnosed type 2 diabetes: a national cohort study. Frontiers In Public Health, 11, Article ID 1265645.
Open this publication in new window or tab >>Dog ownership, glycaemic control and all-cause death in patients with newly diagnosed type 2 diabetes: a national cohort study
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2023 (English)In: Frontiers In Public Health, ISSN 2296-2565, Vol. 11, article id 1265645Article in journal (Refereed) Published
Abstract [en]

AIMS: To evaluate whether dog ownership from the time of type 2 diabetes diagnosis improved glycaemic control, increased achievement of major guideline treatment goals or reduced the risk of all-cause death.

METHODS: Patients diagnosed with type 2 diabetes were followed by linkage of four Swedish national registers covering diabetes, dog ownership, socioeconomics, and mortality. Linear regression was used to estimate the mean yearly change in glycated haemoglobin (HbA1c). Cox survival analysis and logistic regression were used to analyse associations between dog ownership and all-cause death and achievement of treatment goals, respectively.

RESULTS: Of 218,345 individuals included, 8,352 (3.8%) were dog-owners. Median follow-up was 5.2 years. Dog-owners had worse yearly change in HbA1c, and were less likely to reach HbA1c, low-density lipoprotein (LDL), and systolic blood pressure (SBP) treatment goals than non-dog-owners (adjusted odds ratios [95% CI] of 0.93 [0.88-0.97], 0.91 [0.86-0.95], and 0.95 [0.90-1.00], respectively). There was no difference in the risk of all-cause death (adjusted hazard ratio [95% CI] 0.92 [0.81-1.04], dog owners versus not).

CONCLUSION: Owning a dog when diagnosed with diabetes did not lead to better achievement of treatment goals or reduced mortality, but was in fact associated with a smaller reduction in HbA1c and reduced likelihood of achieving treatment goals.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2023
Keywords
Diabetes mellitus type 2, dogs, epidemiology, glycaemic control, lifestyle, mortality
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-110619 (URN)10.3389/fpubh.2023.1265645 (DOI)001133519300001 ()38162624 (PubMedID)2-s2.0-85180887003 (Scopus ID)
Funder
Region Östergötland, RÖ-601981Region VästerbottenUmeå University
Note

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. KR was funded by a County Council of Östergötland international fellowship [grant number RÖ-601981] and the Rolf Luft Foundation for Diabetes Research Fellowship in Memory of Jeanette Bonnier. MW received an Australian National Health and Medical Research Council (NHMRC) [grant number APP1149987]. JC received research grants from the Australian National Health and Medical Research Council (NHMRC) and OR was funded by Västerbotten County Council, and Umeå University.

Available from: 2024-01-09 Created: 2024-01-09 Last updated: 2024-01-18Bibliographically approved
Jansson, S. P., Ramstrand, S., Carlberg, M., Johannesson, G. A., Hiyoshi, A. & Jarl, G. (2023). Exploring potential risk factors for lower limb amputation in people with diabetes: an observational cohort study of 66,565 individuals with diabetes in Sweden. Paper presented at 59th EASD Annual Meeting of the European Association for the Study of Diabetes, Hamburg, Germany, October 2-6, 2023. Diabetologia, 66(Suppl. 1), S114-S115, Article ID 216.
Open this publication in new window or tab >>Exploring potential risk factors for lower limb amputation in people with diabetes: an observational cohort study of 66,565 individuals with diabetes in Sweden
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2023 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 66, no Suppl. 1, p. S114-S115, article id 216Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background and aims: Risk factors for lower limb amputation (LLA) in individuals with diabetes have been under-studied. We examined how demographic and socioeconomic, medical and life-style risk factors may be associated with LLA in people with newly diagnosed diabetes.

Materials and methods: We conducted a cohort study using Swedish national register-linked data. We identified, through the Swedish national diabetes register, all individuals 18 years or older with an incident diabetes diagnosis and no previous amputation from 2007 to 2016. These individuals were followed from the date of the diagnosis to amputation, emigration, death, or the end of the study in 2017, whichever occurred first. Several national Swedish registers were used to obtain data on incident LLA and potential risk factors, including demographic and socioeconomic, medical and lifestyle variables. Variables with more than 40% missing data were excluded from the analysis. The cohort consisted of 66,569 individuals, where of 133 hadan amputation. Cox proportional hazards models were used to obtain hazard ratio (HR) with 95% confidence interval (CI) for associations between demographic and socioeconomic, medical and lifestyle vari-ables and amputation risk. Both unadjusted and mutually adjusted models were fitted.

Results: During the median follow-up time of 4 years there were in total 133 LLA. Based on the model mutually adjusting for all variables, higher age, HR 1.08 (95% CI, 1.05 - 1.10) per year, and being divorced compared with being married, HR 1.67 (1.07 - 2.60) showed positive association. Male sex indicated higher risk, HR 1.57 (1.06 - 2.34). Individuals with an increased foot risk at baseline had increased risk for LLA compared to individuals with healthy feet (neuropathy/angiopathy, HR 4.12 (2.84 - 5.98), previous wounds, HR 8.26 (3.29 - 20.74), ongoing severe foot disease, HR 11.24 (4.82 - 26.23). Insulin treatment compared with diet-only treatment showed HR 2.03 (1.10 - 3.74). Hypertension and HbA1c were not statistically significantly associated with LLA risk. People with obesity had a statistically significant lower risk, HR 0.46 (0.29 - 0.75), compared with individuals with normal weight. Smoking was associated with an increased risk compared with no smoking, HR 1.99 (1.28 - 3.09). Finally, low physical activity (<1 time/week) was associated with an increased risk with a HR of 2.05 (1.30 - 3.23) compared with daily physical activity.

Conclusion: This study found a higher risk for LLA among people with higher age, male sex, who were divorced, who had a higher foot risk group, who were on insulin treatment, lower physical activity levels, and who were smoking. Obesity was associated with lower risk for LLA. Thus, these variables may have important roles in LLA risk among individuals with diabetes.

Place, publisher, year, edition, pages
Springer, 2023
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-109778 (URN)001065473000216 ()
Conference
59th EASD Annual Meeting of the European Association for the Study of Diabetes, Hamburg, Germany, October 2-6, 2023
Funder
NyckelfondenRegion Örebro County
Note

The study was funded by Nyckelfonden and Forskningskommitten at Region Örebro County and by Fonden for rehabilitering och medicinsk forskning.

Available from: 2023-11-21 Created: 2023-11-21 Last updated: 2023-11-21Bibliographically approved
Lundqvist, M. H., Patsoukaki, V., Jansson, S. P. O., Norman, H., Granstam, E., Svensson, M. K., . . . Eriksson, J. W. (2023). Health care registers can be instrumental for endpoint capture in clinical diabetes trials: example of microvascular complications in Swedish patients with type 2 diabetes. Diabetes & Vascular Disease Research, 20(3), Article ID 14791641231179878.
Open this publication in new window or tab >>Health care registers can be instrumental for endpoint capture in clinical diabetes trials: example of microvascular complications in Swedish patients with type 2 diabetes
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2023 (English)In: Diabetes & Vascular Disease Research, ISSN 1479-1641, E-ISSN 1752-8984, Vol. 20, no 3, article id 14791641231179878Article in journal (Refereed) Published
Abstract [en]

AIMS: SMARTEST is a register-based randomized clinical trial (RRCT) that compares dapagliflozin to metformin in early-stage type 2 diabetes. The primary outcome includes progression of microvascular complications based on data from the Swedish National Diabetes Register (NDR). In this sub-study, the aim was to validate microvascular complication variables in the NDR against electronic health records (EHRs).

METHODS: Data were extracted from EHRs of 276 SMARTEST participants with a median observation period of 3 years in the Uppsala, Örebro and Sörmland counties and compared with NDR data. Agreement was determined for all corresponding data entries as well as for progression of microvascular complications after randomization.

RESULTS: The agreement for all corresponding data entries was 98.9% (Intraclass Correlation Coefficient 0.999) for creatinine and eGFR, 95.1% for albuminuria, 91.6% for foot-at-risk and 98.2% for retinopathy status (Kappa 0.67-0.91). The agreement for progression of microvascular complications was 98.0% for CKD stage, 98.9% for albuminuria grade, 96.3% for foot-at-risk grade and 99.6% for retinopathy grade progression (Gwet's AC1 0.96-1.00). CONCLUSION: Microvascular complication variables in the NDR show good agreement with EHR data. The use of a well-established national health care registry, exemplified by the NDR, for endpoint collection in RRCTs such as SMARTEST is supported by this study.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
Type 2 diabetes, diabetes register, endpoint, microvascular complications, register-based randomized clinical trial, validation
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-106404 (URN)10.1177/14791641231179878 (DOI)001019606800001 ()37318227 (PubMedID)2-s2.0-85163904302 (Scopus ID)
Funder
Swedish Research Council, 2018-00904 2019-00978VinnovaSwedish Heart Lung Foundation, 20190403Eye FoundationDiabetesfonden
Note

Funding agencies:

Uppsala-Orebro Regional Research Council RFR-930976

ALF grant

Available from: 2023-06-26 Created: 2023-06-26 Last updated: 2023-08-03Bibliographically approved
Hellgren, M., Wennberg, P., Hedin, K., Jansson, S. P. O., Nilsson, S., Nilsson, G., . . . Bengtsson Boström, K. (2023). Hypertension management in primary health care: a survey in eight regions of Sweden. Scandinavian Journal of Primary Health Care, 41(3), 343-350
Open this publication in new window or tab >>Hypertension management in primary health care: a survey in eight regions of Sweden
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2023 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 41, no 3, p. 343-350Article in journal (Refereed) Published
Abstract [en]

Purpose: To explore hypertension management in primary healthcare (PHC).

Design: Structured interviews of randomly selected PHC centres (PHCCs) from December 2019 to January 2021.

Setting: Seventy-six PHCCs in eight regions of Sweden.

Main outcome measures: Staffing and organization of hypertension care. Methods of measuring blood pressure (BP), laboratory tests, registration of co-morbidities and lifestyle advice at diagnosis and follow-up.

Results: The management of hypertension varied among PHCCs. At diagnosis, most PHCCs (75%) used the sitting position at measurements, and only 13% routinely measured standing BP. One in three (33%) PHCCs never used home BP measurements and 25% only used manual measurements. The frequencies of laboratory analyses at diagnosis were similar in the PHCCs. At follow-up, fewer analyses were performed and the tests of lipids and microalbuminuria decreased from 95% to 45% (p < 0.001) and 61% to 43% (p = 0.001), respectively. Only one out of 76 PHCCs did not measure kidney function at routine follow-ups. Lifestyle, physical activity, food habits, smoking and alcohol use were assessed in ≥96% of patients at diagnosis. At follow-up, however, there were fewer assessments. Half of the PHCCs reported dedicated teams for hypertension, 82% of which were managed by nurses. There was a great inequality in the number of patients per tenured GP in the PHCCs (median 2500; range 1300-11300) patients.

Conclusions: The management of hypertension varies in many respects between PHCCs in Sweden. This might lead to inequity in the care of patients with hypertension.

KEY POINTS: Hypertension is mainly handled in primary healthcare (PHC), and this study shows important dissimilarities in organization and clinical management. Several variants in techniques and measurements of blood pressure were found between PHC centres. Lifestyle, clinical and laboratory assessments decreased at follow-ups compared to at diagnosis, specifically for lipids, microalbuminuria and electrocardiograms. Nearly half of the PHC centres reported that they had dedicated hypertension teams.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
Blood pressure, general practice, hypertension, lifestyle factors, primary health care
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:oru:diva-107523 (URN)10.1080/02813432.2023.2242711 (DOI)001044894600001 ()37561134 (PubMedID)2-s2.0-85167700443 (Scopus ID)
Available from: 2023-08-11 Created: 2023-08-11 Last updated: 2023-12-08Bibliographically approved
Imhagen, A., Karlsson, J., Ohlsson-Nevo, E., Stenberg, E., Jansson, S. P. O. & Hagberg, L. (2023). Levels of Physical Activity, Enjoyment, Self-Efficacy for Exercise, and Social Support Before and After Metabolic and Bariatric Surgery: a Longitudinal Prospective Observational Study. Obesity Surgery, 33(12), 3899-3906
Open this publication in new window or tab >>Levels of Physical Activity, Enjoyment, Self-Efficacy for Exercise, and Social Support Before and After Metabolic and Bariatric Surgery: a Longitudinal Prospective Observational Study
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2023 (English)In: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 33, no 12, p. 3899-3906Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Physical activity (PA) after metabolic and bariatric surgery (MBS) can influence weight loss, health status, and quality of life. Known mediators to participate in PA are enjoyment, self-efficacy, and social support. Little is known about PA behavior in MBS individuals. The aim of this study was to explore levels of PA and the PA mediators enjoyment, self-efficacy, and social support before and after MBS and to investigate changes over time.

METHODS: Adults scheduled to undergo MBS were recruited from a Swedish university hospital. Accelerometer-measured and self-reported PA, body weight, and PA mediators were collected at baseline and at 12 to 18 months post-surgery.

RESULTS: Among 90 individuals included, 50 completed the follow-up assessment and had valid accelerometer data. Sedentary time (minutes/day) was unchanged, but sedentary time as percentage of wear time decreased significantly from 67.2% to 64.5% (p<0.05). Time spent in light PA and total PA increased significantly from 259.3 to 288.7 min/day (p < 0.05) and from 270.5 to 303.5 min/day (p < 0.01), respectively. Step counts increased significantly from 6013 to 7460 steps/day (p < 0.01). There was a significant increase in self-reported PA, enjoyment, self-efficacy for exercise, and positive social support from family. The increase in PA mediators did not lead to a significant change in time spent in moderate to vigorous PA.

CONCLUSION: The increase in PA-mediators was not associated with an increase in moderate to vigorous PA, but the strengthened PA mediators suggest potential for an increase in moderate to vigorous PA in patients undergoing MBS.

Place, publisher, year, edition, pages
Springer, 2023
Keywords
Accelerometer, Enjoyment, Mediators, Metabolic and bariatric surgery, Physical activity, Self-efficacy, Social support
National Category
Sport and Fitness Sciences
Identifiers
urn:nbn:se:oru:diva-108983 (URN)10.1007/s11695-023-06887-7 (DOI)001084516200002 ()37837533 (PubMedID)2-s2.0-85174171905 (Scopus ID)
Available from: 2023-10-16 Created: 2023-10-16 Last updated: 2024-01-12Bibliographically approved
Eriksson, J., Bennet, L., Eliasson, B., Leksell, J., Jansson, S. P. O., Kristofi, R., . . . Sundström, J. (2023). Metformin or SGLT2 inhibitor as 1st line treatment of type 2 diabetes? Design and interim results of the SMARTEST trial. Paper presented at IDF World Diabetes Congress 2022, Lissabon, Portugal, December 5-8, 2022. Diabetes Research and Clinical Practice, 197(Supl. 1), Article ID IDF2022-0.
Open this publication in new window or tab >>Metformin or SGLT2 inhibitor as 1st line treatment of type 2 diabetes? Design and interim results of the SMARTEST trial
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2023 (English)In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 197, no Supl. 1, article id IDF2022-0Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Metformin is generally recommended as 1 st line medication in T2D. However, there is no compelling evidence of its superiority in preventing diabetes complications. SGLT2 inhibitors prevent cardiovascular mortality, heart failure and renal impairment in T2D patients at high cardiovascular risk.

Aim: To assess whether an SGLT2 inhibitor is superior to metformin in preventing organ complications and premature death in early-stage T2D.

Method: The SMARTEST study (SGLT2 inhibitor or Metformin As standaRd Treatment of Early Stage Type 2 diabetes) is a registry-based trial in primary care. Participants are included via on-site or video visits at 31 centers across Sweden; T2D <4 yr; drugnaïve (currently 31%) or montherapy; no cardiorenal diseases. Randomizaton 1:1, open label metformin (individualized dose) or dapagliflozin 10 mg/day. Diet, exercise and other medications are stipulated according to national guidelines. Patients are followed 2–6 yrs.

Endpoints are collected using NDR and the national Patient Registry. The study will close when 844 primary endpoint events have occurred, giving 90% power to detect a HR of 0.8 for dapagliflozin vs metformin. Primary composite endpoint: time to death, myocardial infarction, stroke, heart failure or appearance/progression of microvascular complications (retinopathy, nephropathy, diabetic foot lesions). Other endpoints include: need for insulin therapy; blood pressure, BMI, HbA1c, PROM and health economy.

Results: From late 2019 until May 2022 1100 patients are included. 38% are females, mean age is 60 years and HbA1c 46.5 mmol/mol (6.4%). So far, the primary endpoint event rate is 11/100 patient years (PY), whereas 7/100 PY was estimated from previous data. Nephropathy and foot-at-risk had high rates (6 and 3/100 PY) but MACE was rare (1/100 PY). The recruitment target is 2700 participants, expected by end 2023.

Conclusion: Final results are expected in 2025 and can challenge or, equally important, reinforce the current metformin paradigm in early T2D. Event rates are higher than previously recognized for nephropathy and diabetic foot problems but lower for MACE.

Place, publisher, year, edition, pages
Elsevier, 2023
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-107004 (URN)10.1016/j.diabres.2023.110382 (DOI)001032097300119 ()
Conference
IDF World Diabetes Congress 2022, Lissabon, Portugal, December 5-8, 2022
Available from: 2023-07-06 Created: 2023-07-06 Last updated: 2023-08-28Bibliographically approved
Seidu, S., Cos, X., Brunton, S., Harris, S. B., Jansson, S. P. O., Mata-Cases, M., . . . Khunti, K. (2022). 2022 update to the position statement by Primary Care Diabetes Europe: a disease state approach to the pharmacological management of type 2 diabetes in primary care. Primary Care Diabetes, 16(2), 223-244
Open this publication in new window or tab >>2022 update to the position statement by Primary Care Diabetes Europe: a disease state approach to the pharmacological management of type 2 diabetes in primary care
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2022 (English)In: Primary Care Diabetes, ISSN 1751-9918, E-ISSN 1878-0210, Vol. 16, no 2, p. 223-244Article, review/survey (Refereed) Published
Abstract [en]

Type 2 diabetes and its associated comorbidities are growing more prevalent, and the complexity of optimising glycaemic control is increasing, especially on the frontlines of patient care. In many countries, most patients with type 2 diabetes are managed in a primary care setting. However, primary healthcare professionals face the challenge of the growing plethora of available treatment options for managing hyperglycaemia, leading to difficultly in making treatment decisions and contributing to treatment and therapeutic inertia. This position statement offers a simple and patient-centred clinical decision-making model with practical treatment recommendations that can be widely implemented by primary care clinicians worldwide through shared-decision conversations with their patients. It highlights the importance of managing cardiovascular disease and elevated cardiovascular risk in people with type 2 diabetes and aims to provide innovative risk stratification and treatment strategies that connect patients with the most effective care.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Cardiovascular disease, Cardiovascular risk factors, Chronic kidney disease, Elderly, Heart failure, Multimorbidity, Patient-centred care, Primary care, Shared decision making, Therapeutic adherence, Therapeutic inertia, Type 2 diabetes
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-97587 (URN)10.1016/j.pcd.2022.02.002 (DOI)000813410400001 ()35183458 (PubMedID)2-s2.0-85124673733 (Scopus ID)
Note

Funding agency:

Applied Research Collaboration -East Midlands

Available from: 2022-02-21 Created: 2022-02-21 Last updated: 2022-08-04Bibliographically approved
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