Predicting the effectiveness of insulin pump therapy on glycemic control in clinical practice: a retrospective study of patients with type 1 diabetes from 10 outpatient diabetes clinics in Sweden over 5 years.

Background: Multicenter long-term studies of predictors for the effectiveness of continuous subcutaneous insulin infusion (CSII) in clinical practice are lacking. We hypothesized that there are substantially greater reductions in hemoglobin A1c (HbA1c) in patients with poor glycemic control and that other predictors may also exist.

Subjects And Methods: We used data from 10 outpatient diabetic clinics in Sweden and studied CSII treatment over 5 years.

Impact of short periods with worsened or improved INR control on life expectancy and QALYs in patients with atrial fibrillation.

Introduction: Warfarin-treated patients with poor international normalized ratio (INR) control, measured with time in therapeutic range (TTR) or the standard deviation of transformed INR (SDTINR), have an increased risk for clinical events. To what extent only a short period with an altered INR control may influence outcomes remains unknown. This study assessed the impact of transient periods of worsened or improved INR control on life expectancy and quality-adjusted life years (QALYs) among warfarin-treated patients with atrial fibrillation (AF) using both metrics.

Effect on glycemic control by short- and long-term use of continuous glucose monitoring in clinical practice.

Background: In Sweden, patients with diabetes mellitus frequently receive short-term (<3 months) continuous glucose monitoring (CGM) to study glucose patterns or long-term CGM to treat poor glycemic control or severe hypoglycemia. The effects of CGM on glycemic control in clinical practice in relation to indication and duration of use has not been completely studied.

Methods: Patients with diabetes, among which 99% were diagnosed as type 1, receiving CGM at 10 outpatient clinics in Sweden were studied retrospectively.

The relationship between the exposure time of insulin glargine and risk of breast and prostate cancer: an observational study of the time-dependent effects of antidiabetic treatments in patients with diabetes.

Aims: To elucidate methodological questions in assessing the relationship between insulin treatment and cancer, since the risk of tumour growth generally increases with longer exposure time and higher dose of a growth promoting substance.

Methods: Continuous hazard functions for risk of breast and prostate cancer were estimated in relation to exposure of insulin glargine among diabetic patients included in the record system, Diab-Base, as well as in the general population in Sweden.

Results: In 7942 female diabetic patients, mean follow-up 7.

Variability of INR and its relationship with mortality, stroke, bleeding and hospitalisations in patients with atrial fibrillation.

Unlabelled: BACKGROUND - RATIONALE FOR STUDY: Atrial fibrillation is associated with an increased risk of stroke and mortality which is reduced by treatment with warfarin. The most commonly used tool to assess the effectiveness of warfarin therapy is the time in therapeutic range (TTR) of International Normalised Ratio (INR) 2.0-3.

The true value of HbA1c as a predictor of diabetic complications: simulations of HbA1c variables.

Aim: The updated mean HbA1c has been used in risk estimates of diabetic complications, but it does not take into account the temporal relationship between HbA1c and diabetic complications. We studied whether the updated mean HbA1c underestimated the risk of diabetic complications.

Method: Continuous HbA1c curves for 10,000 hypothetical diabetes patients were simulated over an average of 7 years.

The effect of insulin lispro on glycemic control in a large patient cohort.

Background: The use of rapid-acting insulin analogs and regular insulin differs considerably in countries throughout the world. We therefore studied how glycemic control has been affected by using insulin lispro in clinical practice over 5 years in 14 hospitals in Sweden.

Methods: We used a time period when most patients had not changed the basal insulin, but only the mealtime insulin.

A method to predict the metabolic effects of changes in insulin treatment in subgroups of a large population based patient cohort.

This case-control study was designed to analyse predictors of the effects on HbA1c levels in 4001 type 1 and type 2 diabetic patients after changing their insulin treatment. Patients from 15 outpatient diabetic clinics were treated with basal insulin and multiple injections of short-acting insulin. The effects on HbA1c of changing from NPH insulin to insulin glargine as basal insulin were studied, compared to patients continuing with NPH insulin.

Optimal INR for prevention of stroke and death in atrial fibrillation: a critical appraisal.

Introduction: Patients with nonvalvular atrial fibrillation are at increased risk for systemic embolism, predominantly disabling stroke. To study how stroke and mortality rates vary with different degrees of anticoagulation reflected by the international normalised ratio (INR) we critically assess information from different sources.

Materials And Methods: 1.

Oral anticoagulation and risk of death: a medical record linkage study.

Objective: To study how mortality varies with different degrees of anticoagulation reflected by the international normalised ratio (INR).

Design: Record linkage analysis with death hazard estimated as a continuous function of INR.

Data Sources: 46 anticoagulation clinics in Sweden with computerised medical records.

Home treatment of deep vein thrombosis. An out-patient treatment model with once-daily injection of low-molecular-weight heparin (tinzaparin) in 555 patients.

During a 22-month period, 555 consecutive patients at seven hospitals in the western part of Sweden with an acute deep vein thrombosis (DVT) not involving the iliac vein and not having pulmonary embolism were included in a study testing the efficacy of implementing out-patient treatment. For all patients with a confirmed diagnosis of acute DVT, a folder was used that contained two checklists with detailed instructions for further treatment, one for the doctor and one for the nurse, an information pamphlet for the patient and prepared prescriptions for low-molecular-weight heparin (LMWH) tinzaparin (Innohep) of 175 anti-Xa IU/kg body weight subcutaneously once daily and warfarin. Patients not requiring hospitalisation, according to strict guidelines, were then eligible for treatment as out-patients.