Liraglutide treatment reduced interleukin-6 in adults with type 1 diabetes but did not improve established autonomic or polyneuropathy.

Aims: Type 1 diabetes can be complicated with neuropathy that involves immune-mediated and inflammatory pathways. Glucagon-like peptide-1 receptor agonists such as liraglutide, have shown anti-inflammatory properties, and thus we hypothesized that long-term treatment with liraglutide induced diminished inflammation and thus improved neuronal function.

Methods: The study was a randomized, double-blinded, placebo-controlled trial of adults with type 1 diabetes and confirmed symmetrical polyneuropathy.

The degree of autonomic modulation is associated with the severity of microvascular complications in patients with type 1 diabetes.

Objective: The objective of this study was to elucidate whether the degree of autonomic modulation is associated with the degree of microvascular complications in patients with type 1 diabetes.

Methods: A total of 290 type 1 individuals with diabetes were randomly recruited during normal visits to outpatient clinics at 4 Danish hospitals. The degree of autonomic modulations was quantified by measuring heart rate variability (HRV) during passive spectral analysis and active tests (valsalva ratio [VT], response to standing [RT], and deep breathing [E:I]).

Cardiovascular autonomic neuropathy is associated with macrovascular risk factors in type 2 diabetes: new technology used for routine large-scale screening adds new insight.

The objective was to identify the presence of cardiovascular autonomic neuropathy (CAN) in a cohort of individuals with diabetes in outpatient clinics from 4 different parts of Denmark and to explore the difference between type 1 and type 2 diabetes in relation to CAN. The DAN-Study is a Danish multicenter study focusing on diabetic autonomic neuropathy. Over a period of 12 months, 382 type 1 and 271 type 2 individuals with diabetes were tested for CAN.

Interleukin-1 antagonism in type 1 diabetes of recent onset: two multicentre, randomised, double-blind, placebo-controlled trials.

Background: Innate immunity contributes to the pathogenesis of autoimmune diseases, such as type 1 diabetes, but until now no randomised, controlled trials of blockade of the key innate immune mediator interleukin-1 have been done. We aimed to assess whether canakinumab, a human monoclonal anti-interleukin-1 antibody, or anakinra, a human interleukin-1 receptor antagonist, improved β-cell function in recent-onset type 1 diabetes.

Methods: We did two randomised, placebo-controlled trials in two groups of patients with recent-onset type 1 diabetes and mixed-meal-tolerance-test-stimulated C peptide of at least 0·2 nM.

Lifestyle diseases and cardiovascular risk factors are interrelated to deficiencies of major substrates in ATP synthesis.

Recent studies on diabetes and metabolic syndrome indicate a common disturbance of inorganic phosphate (Pi) metabolism. Pi is an important substrate in the formation of adenosine triphosphate (ATP), and many lifestyle diseases and cardiovascular risk factors similarly show deficiencies in either 1 or 2 major components of ATP synthesis. Age, male gender, hypertension, obesity, hypertriglyceridemia, metabolic syndrome, and diabetes mellitus are all associated with hypophosphatemia.

Disturbance of inorganic phosphate metabolism in diabetes mellitus: its impact on the development of diabetic late complications.

The pathogenesis of diabetic late complications (DLC) is multifactorial. Studies of mechanisms leading to early functional microvascular changes in retina and kidneys point towards a disturbance in the metabolism of inorganic phosphate (Pi) in diabetes. Since tissue hypoxia and reduced high energy phosphates may be important factors in the development of DLC, the influence of Pi concentration on the metabolism and function of the erythrocytes and renal tubular cells, as well as the relationship of the concentration of Pi to total oxygen consumption, have been reviewed.

Change from oral antidiabetic therapy to insulin and risk of urinary tract infections in Type 2 diabetic patients: a population-based prescription study.

Background: Diabetes is a risk factor for urinary tract infections (UTI), but the impact of insulin treatment and glycaemic control on UTI risk is not clear.

Methods: We determined the risk of antibiotic-treated UTI episodes in a population-based cohort of 2737 Type 2 diabetic patients who switched from oral antidiabetic drug (OAD) to insulin therapy. Each patient was observed for 365 days before and after the switch date, excluding a 120-day time window around this date.

Disturbance of inorganic phosphate metabolism in diabetes mellitus: clinical manifestations of phosphorus-depletion syndrome during recovery from diabetic ketoacidosis.

The acute effects of intracellular phosphate depletion and hypophosphatemia on organs and tissues in and during recovery from diabetic ketoacidosis (DKA) have been reviewed. When insufficient phosphate and/or oxygen are available for high energy phosphate synthesis, cell homeostasis cannot be maintained and cell integrity may be impaired. The clinical consequences are recognized as occasional cause of morbidity and mortality.

The North Jutland County Diabetic Retinopathy Study (NCDRS).

Purpose: This study set out to map the associations between retinal lesions, visual acuity (VA) and the presence of clinically significant macular oedema (CSMO) in diabetes subjects.

Methods: This cross-sectional study comprised 656 type 1 and 328 type 2 diabetes subjects undergoing retinopathy screening in the County of North Jutland, Denmark. Numbers of specific retinal lesions were quantified from retinal photographic recordings.

Disturbance of inorganic phosphate metabolism in diabetes mellitus: temporary therapeutic intervention trials.

A paradoxical metabolic imbalance in inorganic phosphate occurs from the early onset of diabetes and may lead to a reduction of high energy phosphates and tissue hypoxia. These changes take place in the cells and tissues in which the entry of glucose is not controlled by insulin, and particularly in poorly regulated diabetes patients in whom long-term vascular complications are more likely to occur. Several therapeutic intervention trials have been carried out, including assessment of optimal glucose regulation, the effect of dietary inclusion of calcium diphosphate and pharmaceutical intake of etidronate disodium (EHDP), but none of these modalities wholly overcome the problem.

Diabetes, glycemic control, and risk of hospitalization with pneumonia: a population-based case-control study.

Objective: To examine whether diabetes is a risk factor for hospitalization with pneumonia and to assess the impact of A1C level on such risk.

Research Design And Methods: In this population-based, case-control study we identified patients with a first-time pneumonia-related hospitalization between 1997 and 2005, using health care databases in northern Denmark. For each case, 10 sex- and age-matched population control subjects were selected from Denmark's Civil Registration System.

Type 2 diabetes and pneumonia outcomes: a population-based cohort study.

Objective: We sought to examine whether type 2 diabetes increases risk of death and complications following pneumonia and to assess the prognostic value of admission hyperglycemia.

Research Design And Methods: This was a population-based cohort study of adults with a first-time hospitalization for pneumonia between 1997 and 2004 (n = 29,900) in northern Denmark. Information on diabetes, comorbidity, laboratory findings, pulmonary complications, and bacteremia was obtained from medical databases.

Statin use and mortality within 180 days after bacteremia: a population-based cohort study.

Objective: To examine the association between preadmission statin use and mortality among patients with bacteremia in a population-based setting.

Design: Observational study based on prospective registration of bacteremia episodes and mortality over a 6-yr period.

Setting: North Jutland County, Denmark (population, 500,000).

Diabetes mellitus as a risk and prognostic factor for community-acquired bacteremia due to enterobacteria: a 10-year, population-based study among adults.

Diabetes was examined as a risk factor and a prognostic factor for community-acquired bacteremia caused by Escherichia coli and other enterobacteria in a series of 1317 adult case patients, with 10 population control subjects per case. Persons with diabetes had a substantially increased risk for enterobacterial bacteremia (adjusted odds ratio, 2.9; 95% confidence interval, 2.

Diabetes patients' ability to estimate dietary carbohydrate content for use in a decision support system.

The aim of the study was to assess Type 1 (insulin-dependent) diabetic patients' ability to give valid information of the dietary carbohydrate (CHO) intake and to use the log function of a blood glucose meter for easy transfer of data to a decision support system. 18 Type 1 diabetic patients were enrolled from the Diabetes Outpatient Clinic at the Department of Endocrinology, Aalborg Hospital, Denmark. The patients were divided in subgroups of 4 or 5 patients and was instructed by the dietitian how to estimate the CHO intake and by the doctor in the use of the Accutrend DM blood glucose meter.

Risk of community-acquired pneumococcal bacteremia in patients with diabetes: a population-based case-control study.

Objective: We conducted this population-based case-control study to examine whether diabetes is associated with an increased risk of community-acquired pneumococcal bacteremia.

Research Design And Methods: We included 598 cases in the North Jutland County Bacteremia Registry, Denmark, with residence in the county and a first hospitalization for community-acquired pneumococcal bacteremia from 1992 through 2001. Ten sex- and age-matched population control subjects per case were selected, using a unique personal identifier.

Diabetes and outcome of community-acquired pneumococcal bacteremia: a 10-year population-based cohort study.

Objective: Patients with diabetes may carry a higher case fatality of invasive pneumococcal infection compared with nondiabetic patients due to decreased immunity, risk of metabolic derangement, or angiopathy. We conducted a population-based cohort study to assess the impact of diabetes on mortality within 90 days in patients with pneumococcal bacteremia.

Research Design And Methods: All patients with community-acquired pneumococcal bacteremia in North Jutland County, Denmark, from January 1992 to December 2001 were retrieved from the County Bacteremia Registry.

[Photographic screening for diabetic retinopathy in the county of North Jutland. The first fully digitalized telemedicine-screening clinic].

Screening for diabetic retinopathy was introduced in Denmark in 1988. At present, screening is carried out in four of the 14 counties, thus being available to a minority of diabetic subjects. According to the WHO but also the National Board of Health, all diabetic patients should undergo screening for diabetic retinopathy.