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  • 1
    Electronic Resource
    Electronic Resource
    Prevalence of diabetes mellitus in elderly men aged 65 to 84 years in eastern and western Finland (1986)
    Springer
    Diabetologia 29 (1986), S. 611-615 
    Details
    ISSN: 1432-0428
    Keywords: Type 2 diabetes ; diabetes prevalence ; blood glucose ; glucose tolerance ; epidemiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We studied the prevalence of diabetes mellitus in men aged 65 to 84 years in Finland. The study sample consisted of 763 men, the survivors of the Finnish cohort of the "Seven Countries Study" first examined in 1959. The participation rate in the present survey was 94%. Blood glucose, fasting and 2 h after a 75-g oral glucose load, was determined from capillary blood. Current WHO criteria for diabetes mellitus were used. The mean fasting blood glucose level, adjusted for age and body mass index, was higher in east than west Finland. It rose with age in both areas. The prevalence of diabetes was 38% in the east and 36% in west Finland. About one-third of the men had impaired glucose tolerance. In the age group 75 to 79 years, the prevalence of diabetes was 65% in the east and 50% in the west. No systematic variation in the prevalence of impaired glucose tolerance with age was found. The mean levels of body mass index decreased with age in the same way in men with diabetes, impaired glucose tolerance and normal glucose tolerance. Body mass index was not higher in men with diabetes or impaired glucose tolerance than in men with normal glucose tolerance.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00869258
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  • 2
    Electronic Resource
    Electronic Resource
    Concordance for Type 1 (insulin-dependent) and Type 2 (non-insulin-dependent) diabetes mellitus in a population-based cohort of twins in Finland (1992)
    Springer
    Diabetologia 35 (1992), S. 1060-1067 
    Details
    ISSN: 1432-0428
    Keywords: Diabetes mellitus ; twins ; prevalence ; concordance ; heritability
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We studied the cumulative incidence, concordance rate and heritability for diabetes mellitus in a nationwide cohort of 13,888 Finnish twin pairs of the same sex. The twins were born before 1958 and both co-twins were alive in 1967. Data on diabetes were derived through computerized record linkage from death certificates, the National Hospital Discharge Register and the National Drug Register. Records were reviewed in order to assign a diagnostic category to the 738 diabetic patients identified. Of these patients 109 had Type 1 (insulin-dependent) diabetes, 505 Type 2 (non-insulin-dependent) diabetes, 46 gestational diabetes, 24 secondary diabetes, 38 impaired glucose tolerance and 16 remained unclassified. The cumulative incidence of diabetes was 1.4 % in men and 1.3 % in women aged 28–59 years and 9.3 % and 7.0 % in men and women aged 60 years and over, respectively. The cumulative incidence did not differ between monozygotic and dizygotic twins. The concordance rate for Type 1 diabetes was higher among monozygotic (23 % probandwise and 13 % pairwise) than dizygotic twins (5 % probandwise and 3 % pairwise). The probandwise and pairwise concordance rates for Type 2 diabetes were 34% and 20% among monozygotic tiwns and 16% and 9 % in dizygotic twins, respectively. Heritability for Type 1 diabetes was greater than that for Type 2 where both genetic and environmental effects seemed to play a significant role.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02221682
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  • 3
    Electronic Resource
    Electronic Resource
    Epidemiology of childhood diabetes mellitus in Finland — background of a nationwide study of Type 1 (insulin-dependent) diabetes mellitus (1992)
    Springer
    Diabetologia 35 (1992), S. 70-76 
    Details
    ISSN: 1432-0428
    Keywords: Type 1 (insulin-dependent) diabetes mellitus ; epidemiology ; genetic-environmental interaction ; incidence ; familial occurrence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A nationwide study of childhood Type 1 (insulin-dependent) diabetes mellitus was established in 1986 in Finland, the country with the highest incidence of this disease worldwide. The aim of the project called “Childhood Diabetes in Finland” is to evaluate the role of genetic, environmental and immunological factors and particularly the interaction between genetic and environmental factors in the development of Type 1 diabetes. From September 1986 to April 1989, 801 families with a newly-diagnosed child aged 14 years or younger at the time of diagnosis were invited to participate in this study. The vast majority of the families agreed to participate in the comprehensive investigations of the study. HLA genotypes and haplotypes were determined in 757 families (95%). Our study also incorporates a prospective family study among non-diabetic siblings aged 3–19 years, and two case-control studies among the youngonset cases of Type 1 diabetes. During 1987–1989, the overall incidence of Type 1 diabetes was about 35.2 per 100,000 per year. It was higher in boys (38.4) than in girls (32.2). There was no clear geographic variation in incidence among the 12 provinces of Finland. Of the 1,014 cases during these 3 years only six cases were diagnosed before their first birthday. The incidence was high already in the age group 1–4-years old: 33.2 in boys and 29.5 in girls. Of the 801 families 90 (11.2%) were multiple case families, of which 66 had a parent with Type 1 diabetes at the time of diagnosis of the proband. The prevalence of Type 1 diabetes in the parents of these newly-diagnosed diabetic children was higher in fathers (5.7%) than in mothers (2.6%).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00400854
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  • 4
    Electronic Resource
    Electronic Resource
    Evidence for importance of gender and birth cohort for risk of IDDM in offspring of IDDM parents (1995)
    Springer
    Diabetologia 38 (1995), S. 975-982 
    Details
    ISSN: 1432-0428
    Keywords: Key words Insulin-dependent diabetes mellitus ; epidemiology ; cumulative risk ; sex differential ; family history.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The risk of developing diabetes is higher in offspring of fathers than of mothers with insulin-dependent diabetes mellitus (IDDM). The reasons for this sex differential are unclear, as early studies were often selected and relatively small. We conducted a prospective study on the risk of IDDM in a cohort of 9,453 offspring from 5,255 Finnish parents with diabetes diagnosed before age 30 years. Age of first admission to the hospital was considered to be the age of diagnosis of IDDM in the offspring; IDDM occurred in 248 offspring. The risk of IDDM tended to be lower in the offspring of the same gender as the diabetic parent (adjusted risk ratio (RR) 0.78; p = 0.50). When offspring were of same gender as the diabetic parent, male offspring had a higher risk of IDDM than female offspring (RR 2.28; 95 % confidence interval 1.53–3.38), whereas if the gender of the diabetic parent and the offspring were different, the risk in male offspring was lower (RR 0.43; 95 % confidence interval 0.31–0.62). For the offspring of diabetic fathers, the cumulative risk by the age of 20 was higher (7.6 %) than for those with diabetic mothers (3.5 %) (p 〈 0.0001). In a multivariate analysis statistically significant predictors of IDDM in the offspring were the sex of the parent, the year of birth and the birth order of the offspring. The risk of IDDM in the offspring increased by 9 % per year of birth cohort. By age 20, the cumulative risk of developing IDDM in the offspring of diabetic parents was 5.3 %, 10 times higher than in the background population. It is likely that genetic factors seem to have played a major role in the continuous increase of IDDM incidence in Finnish children. [Diabetologia (1995) 38: 975–982]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00400588
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  • 5
    Electronic Resource
    Electronic Resource
    Large incidence variation of Type I diabetes in central-southern Italy 1990–1995: lower risk in rural areas (1999)
    Springer
    Diabetologia 42 (1999), S. 789-792 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Insulin-dependent diabetes mellitus ; Type I diabetes ; epidemiology ; incidence ; childhood ; urban ; rural.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Aims/hypothesis. To evaluate the relation between the incidence of childhood Type I (insulin-dependent) diabetes mellitus and the degree of urbanization in the central-southern part of Italy. Methods. The incidence was determined in two areas: area A encompasses 3 regions of central-eastern Italy (Marche, Abruzzo, Umbria), whereas area B encompasses one southern region (Campania). During 1990–1995, 706 children aged 14 or under with insulin-dependent diabetes mellitus of recent onset were registered. The completeness of the case ascertainment in the registries analysed separately for each region was high, ranging from 96.3 % to 99 %. Results. The age-standardized incidence was higher in area A (9.6 per 100 000 person per year; 95 % confidence interval: 8.5–10.8) than in area B (5.4 per 100 000 person per year; 95 % confidence interval: 4.9–6.0). In both areas the standardized incidence ratios increased with the degree of urbanization (chi-squared for trend: area A = 140, p 〈 0.0001; area B = 79, p 〈 0.0001). The highest standardized incidence ratios were in the most urban communities. Conclusion/interpretation. This study showed a statistically significant difference in incidence of childhood insulin-dependent diabetes mellitus among different areas of the continental peninsula of Italy. People living in the rural communities appear to have a lower risk. [Diabetologia (1999) 42: 789–792]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250051228
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  • 6
    Electronic Resource
    Electronic Resource
    A review of the recent epidemiological data on the worldwide incidence of Type 1 (insulin-dependent) diabetes mellitus (1993)
    Springer
    Diabetologia 36 (1993), S. 883-892 
    Details
    ISSN: 1432-0428
    Keywords: Type 1 (insulin-dependent) diabetes mellitus ; epidemiology ; incidence ; geographical distribution
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Nearly 70 registries from more than 40 countries have collected and published incidence data of childhood Type 1 (insulin-dependent) diabetes mellitus up to the end of the 1980s. The majority of incidence data comes from regions of high incidence i. e. from Europe and North American. All these published data facilitate the descriptive comparison of incidence and variation of the occurrence of Type 1 diabetes roughly throughout the northern hemisphere. The aim of this paper is to review and compare the most recent epidemiology data on the incidence of Type 1 diabetes among children under the age of 15 years. A clear difference in incidence appeared between northern and southern hemisphere with no countries below the equator having an incidence greater than 15.0 per 100,000. In contrast above the equator the disease is common. Between continents the variation in incidence showed that the lowest incidences were found in Asia, followed by Oceania (Australia and New Zealand), South and North America, and the highest rates were in Europe. The incidence varied from 0.6 per 100,000 in Korea and Mexico to 35.3 per 100,000 in Finland showing prominent worldwide variation in incidence of Type 1 diabetes. The largest intracontinental variation in incidence appeared in Europe, varying from the highest in Finland to the lowest (4.6 per 100,000)_in northern Greece. The highest incidence in the world was in northern Europe, but within the continent scale there were some striking exceptions from the overall level of incidence. In Iceland, the northern-most island nation in Europe, the incidence is only one-half of that in Norway and Sweden and one-third of that in Finland. In contrast, in Sardinia in southern Europe the Type 1 diabetes incidence is virtually the same as in Finland, three times higher than overall incidence in Europe. Large variation was also seen in small “pockets” of countries, particularly in the Baltic sea region. The worldwide variation in incidence reflects the distribution of ethnic populations and demonstrates the importance of the differential genetic susceptibility between populations.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02374468
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  • 7
    Electronic Resource
    Electronic Resource
    Diabetes mellitus, impaired glucose tolerance and mortality among elderly men: The Finnish cohorts of the seven countries study (1992)
    Springer
    Diabetologia 35 (1992), S. 760-765 
    Details
    ISSN: 1432-0428
    Keywords: Diabetes mellitus ; elderly ; mortality ; cardiovascular disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We studied the association of glucose intolerance with total and cause-specific mortality during a 5-year follow-up of 637 elderly Finnish men aged 65 to 84 years. Total mortality was 276 per 1000 for men aged 65 to 74 years and 537 per 1000 for men aged 75 to 84 years. Five-year total mortality adjusted for age was 364 per 1000 in diabetic men, 234 per 1000 in men with impaired glucose tolerance and 209 per 1000 in men with normal glucose tolerance. The relative risk of death among diabetic men was 2.10 (95% confidence interval 1.26 to 3.49) and among men with impaired glucose tolerance 1.17 (95% confidence interval 0.71 to 1.94) times higher compared with men with normal glucose tolerance. Cardiovascular disease was the most common cause of death in every glucose tolerance group. The multivariate adjusted relative risk of cardiovascular death was increased (1.55) in diabetic patients, albeit non-significantly (95% confidence interval 0.84 to 2.85). Diabetes resulted in an increased risk of cardiovascular mortality among men aged 65–74 years but not among the 75–84-year-old men. Relative risk of death from non-cardiovascular causes was slightly increased among diabetic subjects. In conclusion, diabetes mellitus is a significant determinant of mortality among elderly Finnish men.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00429097
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  • 8
    Electronic Resource
    Electronic Resource
    Increasing trend in Type 1 (insulin-dependent) diabetes mellitus in childhood in Finland (1991)
    Springer
    Diabetologia 34 (1991), S. 282-287 
    Details
    ISSN: 1432-0428
    Keywords: Type 1 diabetes ; incidence ; epidemiology ; time trends ; Finland
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The Central Drug Registry in Finland ascertained 5,920 incident cases of Type 1 (insulin-dependent) diabetes mellitus diagnosed under the age of 15 years, during 1965–1984. The incidence was higher for males 29.2/100,000 (95% confidence intervals 28.2–30.2/100,000) than for females 26.1/100,000 (25.1–27.1/100,000). A non-linear increase in incidence with age was confirmed, with peaks at ages 2,9 and 14 years in males and at 3,5–6 and 11 years in females. A significant temporal variation in incidence was found, adjusting for age and sex. During 1965 to 1984 the incidence rose by about 57% or by 2.4% annually. However, a non-linear curve with two incidence peaks in 1978 and 1983 would better describe the temporal pattern than a linear trend. There was no significant difference in the temporal variation between males and females. The changes in diabetes risk appeared to affect proportionally all age groups under 15 years. Two possible mechanisms were explored: a calendar period effect vs a birth cohort effect. The calendar time period effect was significant alone and also when adjusted for the birth cohort effect. One the contrary, the birth cohort effect was not significant, when adjusted for the calendar period effect. In conclusion, over the past two decades, the incidence of childhood Type 1 diabetes in Finland has increased by about 57%. The pattern of change was a steady rising background incidence superimposed by sudden outbreaks suggesting environmental causative factors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00405089
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  • 9
    Electronic Resource
    Electronic Resource
    Evidence for importance of gender and birth cohort for risk of IDDM in offspring of IDDM parents (1995)
    Springer
    Diabetologia 38 (1995), S. 975-982 
    Details
    ISSN: 1432-0428
    Keywords: Insulin-dependent diabetes mellitus ; epidemiology ; cumulative risk ; sex differential ; family history
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The risk of developing diabetes is higher in offspring of fathers than of mothers with insulin-dependent diabetes mellitus (IDDM). The reasons for this sex differential are unclear, as early studies were often selected and relatively small. We conducted a prospective study on the risk of IDDM in a cohort of 9,453 offspring from 5,255 Finnish parents with diabetes diagnosed before age 30 years. Age of first admission to the hospital was considered to be the age of diagnosis of IDDM in the offspring; IDDM occurred in 248 offspring. The risk of IDDM tended to be lower in the offspring of the same gender as the diabetic parent (adjusted risk ratio (RR) 0.78; p=0.50). When offspring were of same gender as the diabetic parent, male offspring had a higher risk of IDDM than female offspring (RR 2.28; 95% confidence interval 1.53–3.38), whereas if the gender of the diabetic parent and the offspring were different, the risk in male offspring was lower (RR 0.43; 95% confidence interval 0.31–0.62). For the offspring of diabetic fathers, the cumulative risk by the age of 20 was higher (7.6%) than for those with diabetic mothers (3.5%) (p〈0.0001). In a multivariate analysis statistically significant predictors of IDDM in the offspring were the sex of the parent, the year of birth and the birth order of the offspring. The risk of IDDM in the offspring increased by 9% per year of birth cohort. By age 20, the cumulative risk of developing IDDM in the offspring of diabetic parents was 5.3%, 10 times higher than in the background population. It is likely that genetic factors seem to have played a major role in the continuous increase of IDDM incidence in Finnish children.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00400588
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  • 10
    Electronic Resource
    Electronic Resource
    Incidence of cardiovascular disease in Type 1 (insulin-dependent) diabetic subjects with and without diabetic nephropathy in Finland (1998)
    Springer
    Diabetologia 41 (1998), S. 784-790 
    Details
    ISSN: 1432-0428
    Keywords: Keywords Diabetes mellitus ; nephropathy ; cardiovascular disease ; epidemiology ; stroke ; coronary heart disease.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary This study evaluates the impact of diabetic nephropathy on the incidence of coronary heart disease, stroke and any cardiovascular disease in the Finnish population, which has a high risk of Type 1 (insulin-dependent) diabetes mellitus and cardiovascular disease. We performed a prospective analysis of the incidence of coronary heart disease, stroke and cardiovascular disease in all Type 1 subjects in the Finnish Type I diabetes mellitus register diagnosed before the age of 18 years between 1 January 1965 and 31 December 1979 nationwide. The effect of age at onset of diabetes, attained age at the end of follow-up, sex, diabetes duration and of the presence of diabetic nephropathy on the risk for cardiovascular disease was evaluated. Cases of nephropathy, coronary heart disease, stroke and all cardiovascular diseases were ascertained from the nationwide Finnish Hospital Discharge Register and National Death Register using computer linkage with the Type I diabetes mellitus register. Of the 5148 Type 1 diabetic patients followed up, 159 had a cardiovascular event of which 58 were coronary heart diseases, 57 stroke events and 44 other heart diseases. There were virtually no cases of cardiovascular disease before 12 years diabetes duration. The cumulative incidence of cardiovascular disease by the age of 40 years was 43 % in Type 1 diabetic patients with diabetic nephropathy, compared with 7 % in patients without diabetic nephropathy, similarly in men and women. The relative risk for Type 1 diabetic patients with diabetic nephropathy compared with patients without diabetic nephropathy was 10.3 for coronary heart disease, 10.9 for stroke and 10.0 for any cardiovascular disease, similarly in men and women. The presence of nephropathy in Type I diabetic subjects increases not only the risk of coronary heart disease, but also of stroke by tenfold. [Diabetologia (1998) 41: 784–790]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001250050988
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