المؤلفون: Svensson, Ann-Marie, Mårtensson, Lena B., Muhli, Ulla H. Hellström

المصدر: International Journal of Qualitative Studies on Health and Well-being. 7(19207):1-12

مصطلحات موضوعية: Well-being, elderly women, narrative, lifeworld, case study, qualitative research

الوصف: In this article, we are concerned with narratives of elderly women's well-being from their perspectives of the latter parts of their life, living at special housing accommodation (SHA) in the context of Swedish elderly care. In focusing on narratives about well-being, we have a two-fold focus: (1) how the elderly women create their own identity and meaning-making based on lifetime experience; and (2) how narratives of well-being are reflected through the filter of life in situ at the SHA. Based on empirical data consisting of well-being narratives, a dialogical performance analysis was undertaken. The results show how relationships with important persons during various stages of life, and being together and enjoying fellowship with other people as well as enjoying freedom and self-determination, are central aspects of well-being. The conclusions drawn are that the characteristic phenomena of well-being (the what) in the narratives are continuity, identity, and sociality for the elderly person, and this is manifested (the how) as a question of contrasting the state of self-management and self-decline.

وصف الملف: electronic

الوصول الحر: https://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-22037Test
https://hj.diva-portal.org/smash/get/diva2:650957/FULLTEXT01.pdfTest

المؤلفون: Åkerblom, Hanna, Franzén, Stefan, Zhou, Caddie, Morén, Åsa, Ottosson, Johan, 1957, Sundbom, Magnus, Eliasson, Björn, Svensson, Ann-Marie, Granstam, Elisabet

المصدر: JAMA ophthalmology. 39(2):200-205

الوصف: Importance: Knowledge of the incidence and progression of diabetic retinopathy (DR) after gastric bypass surgery (GBP) in patients with obesity and diabetes could guide the management of these patients.Objective: To investigate the incidence of diabetic ocular complications in patients with type 2 diabetes after GBP compared with the incidence of diabetic ocular complications in a matched cohort of patients with obesity and diabetes who have not undergone GBP.Design, Setting, and Participants: Data from 2 nationwide registers in Sweden, the Scandinavian Obesity Surgery Registry and the National Diabetes Register, were used for this cohort study. A total of 5321 patients with diabetes from the Scandinavian Obesity Surgery Registry who had undergone GBP from January 1, 2007, to December 31, 2013, were matched with 5321 patients with diabetes from the National Diabetes Register who had not undergone GBP, based on sex, age, body mass index (BMI), and calendar time (2007-2013). Follow-up data were obtained until December 31, 2015. Statistical analysis was performed from October 5, 2018, to September 30, 2019.Exposure: Gastric bypass surgery.Main Outcomes and Measures: Incidence of new DR and other diabetic ocular complications.Results: The study population consisted of 5321 patients who had undergone GBP (3223 women [60.6%]; mean [SD] age, 49.0 [9.5] years) and 5321 matched controls (3395 women [63.8%]; mean [SD] age, 47.1 [11.5] years). Mean (SD) follow-up was 4.5 (1.6) years. The mean (SD) BMI and hemoglobin A1c concentration at baseline were 42.0 (5.7) and 7.6% (1.5%), respectively, in the GBP group and 40.9 (7.3) and 7.5% (1.5%), respectively, in the control group. The mean (SD) duration of diabetes was 6.8 (6.3) years in the GBP group and 6.4 (6.4) years in the control group. The risk for new DR was reduced in the patients who underwent GBP (hazard ratio, 0.62 [95% CI, 0.49-0.78]; P < .001). The dominant risk factors for development of DR at baseline were diabetes duration, hemoglobin A1c concentration, use of insulin, glomerular filtration rate, and BMI.Conclusions and Relevance: This nationwide matched cohort study suggests that there is a reduced risk of developing new DR associated with GBP, and no evidence of an increased risk of developing DR that threatened sight or required treatment.

وصف الملف: print

الوصول الحر: https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-88531Test

المؤلفون: Bjerg, L., Gudbjörnsdottir, Soffia, 1962, Franzen, S., Carstensen, B., Witte, D. R., Jorgensen, M. E., Svensson, Ann-Marie, 1961

المصدر: International Journal of Epidemiology. 50(4):1250-1259

مصطلحات موضوعية: Endocrinology and Diabetes, Endokrinologi och diabetes, Type 1 diabetes, epidemiology, diabetes-related complications, mortality, all-cause mortality, cardiovascular-disease, excess mortality, young-adults, retinopathy, risk, events, trends, rates, age, Public, Environmental & Occupational Health

الوصف: Background: People with type 1 diabetes often live for many years with different combinations of diabetes-related complications. We aimed to quantify how complication duration and total complication burden affect mortality, using data from national registers. Methods: This study included 33 396 individuals with type 1 diabetes, registered in the Swedish National Diabetes Register at any time between 2001 and 2012. Each individual was followed and classified according to their time-updated diabetes-related complication status. The main outcomes were all-cause mortality, cardiovascular (CV) mortality and non-CV mortality. Poisson models were used to estimate the rate of these outcomes as a function of the time-updated complication duration. Results: Overall, 1748 of the 33 396 individuals died during 198 872 person-years of follow-up. Overall, the time-updated all-cause mortality rate ratio (MRR) was 2.25 [95% confidence interval (CI): 1.99-2.54] for patients with diabetic kidney disease, 0.98 (0.82-1.18) for patients with retinopathy and 4.00 (3.56-4.50) for patients with cardiovascular disease relative to individuals without complications. The excess rate was highest in the first period after a diagnosis of CVD, with an 8-fold higher mortality rate, and stabilized after some 5 years. After diagnosis of diabetic kidney disease, we observed an increase in all-cause mortality with an MRR of around 2 compared with individuals without diabetic kidney disease, which stabilized after few years. Conclusions: In this cohort we show that duration of diabetes-related complications is an important determinant of mortality in type 1 diabetes, for example the MRR associated with CVD is highest in the first period after diagnosis of CVD. A stronger focus on time-updated information and thorough consideration of complication duration may improve risk stratification in routine clinical practice.

الوصول الحر: https://gup.ub.gu.se/publication/309573Test

المؤلفون: Hallström, Sara, Hirsch, I. B., Ekelund, M., Sofizadeh, S., Albrektsson, H., Dahlqvist, S., Svensson, Ann-Marie, 1961, Lind, Marcus, 1976

المصدر: Diabetes Technology & Therapeutics. 23(6):425-433

مصطلحات موضوعية: Endocrinology and Diabetes, Endokrinologi och diabetes, Type 1 diabetes, Type 2 diabetes, Continuous glucose monitoring, Glucose, variability, Time in range, randomized clinical-trial, glycemic control, sensing technology, hypoglycemia, liraglutide, multicenter, management, hba(1c), range, Endocrinology & Metabolism

الوصف: Background: Although guidelines advocate similar continuous glucose monitoring (CGM) targets for insulin-treated persons with type 1 diabetes (T1D) and type 2 diabetes (T2D), it is unclear how these persons differ with respect to hypoglycemia, glucose variability, and other CGM metrics in clinical practice. Methods: We used data from 2 multicenter randomized-controlled trials (GOLD and MDI-Liraglutide) where 161 persons with T1D and 124 persons with T2D treated with multiple daily injections were included and monitored with masked CGM. Results: Persons from both cohorts had similar mean glucose levels, 10.9 mmol/L (196 mg/dL) in persons with T1D and 10.8 mmol/L (194 mg/dL) in persons with T2D. Time in hypoglycemia (<3.9 mmol/L [70 mg/dL]) was 5.1% and 1.0% for persons with T1D and T2D, respectively (P < 0.001). Corresponding estimates for the standard deviations of mean glucose levels were 4.4 mmol/L (79 mg/dL) versus 3.0 (54 mg/dL) (P < 0.001), for coefficient of variation 41% versus 28% (P < 0.001), and for time in range 38.2% versus 45.3%, respectively (P = 0.004). Mean C-peptide levels were 0.05 nmol/L and 0.67 nmol/L (P < 0.001) for persons with T1D and T2D, respectively. Conclusions: Persons with T1D compared with persons with T2D treated with multiple daily insulin injections spend considerably more time in hypoglycemia, have higher glucose variability, and less "time in range." This needs to be taken into account in daily clinical care and in recommended targets for CGM metrics.

الوصول الحر: https://gup.ub.gu.se/publication/306982Test

المؤلفون: Rathsman, B., Haas, J., Persson, M., Ludvigsson, J., Svensson, Ann-Marie, 1961, Lind, Marcus, 1976, Franko, M. A., Nystrom, T.

المصدر: Journal of Internal Medicine. 289(6):873-886

مصطلحات موضوعية: Clinical Medicine, Klinisk medicin, cardiovascular-disease, young-adults, onset, progression, mortality, complications, adolescents, prevalence, hba(1c), search, General & Internal Medicine

الوصف: Background Microvascular complications are common in people with diabetes, where poor glycaemic control is the major contributor. The aim of this study was to explore the association between elevated LDL cholesterol levels and the risk of retinopathy or nephropathy in young individuals with type 1 diabetes. Methods This was a nationwide observational population-based cohort study, including all children and adults with a duration of type 1 diabetes of <= 10 years, identified in the Swedish National Diabetes Register between 1998 and 2017. We calculated the crude incidence rates with 95% confidence intervals (CIs) and used multivariable Cox regression to estimate crude and adjusted hazard ratios (HRs) of retinopathy or nephropathy in four LDL cholesterol categories: <2.6 (Reference), 2.6-3.4, 3.4-4.1 and > 4.1 mmol L-1. Results In total, 11 024/12 350 (retinopathy/nephropathy, both cohorts, respectively) children and adults (median age 21 years, female 42%) were followed up to 28 years from diagnosis until end of study. Median duration of diabetes when entering the study was 6 and 7 years in the retinopathy and nephropathy cohort, respectively. Median LDL cholesterol was 2.4 mmol L-1, and median HbA1c level was 61 mmol mol(-1) (7.7 %). After multivariable adjustment, the HRs (95% CI) for retinopathy in individuals with LDL cholesterol levels of 2.6-3.4, 3.4-4.1 or > 4.1 mmol L-1 were as follows: 1.13 (1.03-1.23), 1.16 (1.02-1.32) and 1.18 (0.99-1.41), compared with the reference. The corresponding numbers for nephropathy were as follows: 1.15 (0.96-1.32), 1.30 (1.03-1.65) and 1.41 (1.06-1.89). Conclusions Young individuals with type 1 diabetes exposed to high LDL cholesterol levels have an increased risk of retinopathy and nephropathy independent of glycaemia and other identified risk factors for vascular complications.

الوصول الحر: https://gup.ub.gu.se/publication/301072Test

المؤلفون: Svensson, Ann-Marie, 1961, Toll, Anders, Lebrec, Jeremie, Miftaraj, Mervete, Franzén, Stefan, 1967, Eliasson, Björn, 1959

المصدر: Diabetes, obesity & metabolism. 23(3):720-729

مصطلحات موضوعية: Endocrinology and Diabetes, Endokrinologi och diabetes

الوصف: To compare treatment persistence in patients with type 2 diabetes mellitus initiating the glucagon-like peptide-1 receptor agonists (GLP-1 RAs) dulaglutide, exenatide once-weekly (QW), liraglutide, or lixisenatide in routine clinical practice in Sweden and assess clinical outcomes.We performed a retrospective study using data from several nationwide Swedish health registries, including the National Diabetes Register and other mandatory and population-based registries. Individual level data were collected from 17,361 patients who initiated GLP-1 RA treatment between the 23 May 2015 and the 15 Oct 2017, up to 2.5years post-index (treatment start date). Treatment persistence and modification, predictors of discontinuation, glycated hemoglobin A1c (HbA1c), and body weight were recorded. Non-persistence was defined as a treatment gap of >45days. Treatment modification included switching and augmentation. Confounding was addressed through the use of propensity scores.Treatment persistence was higher and treatment modifications were lower in patients initiating dulaglutide, compared with those on exenatide QW, liraglutide, and lixisenatide. Patients who remained on the same treatment for 1-year post-index experienced greater HbA1c reductions and a steadier decrease in body weight, compared with those who switched treatment.Our study suggests that in clinical practice in Sweden, there is a greater persistence of treatment among patients initiating dulaglutide, compared with those on exenatide QW, liraglutide, and lixisenatide. Persistence with the index GLP-1 RA was closely correlated with positive clinical outcomes and should thus be considered a critical factor of patient-centric treatment in Sweden. This article is protected by copyright. All rights reserved.

الوصول الحر: https://gup.ub.gu.se/publication/299705Test

المؤلفون: Muhli, Ulla Hellström, Svensson, Ann-Marie

المصدر: https://www.intechopen.com/books/6013Test.

مصطلحات موضوعية: Well-being and Quality of Life - Medical Perspective

الوصف: In this chapter, we are concerned with the well-being of people in old age, living at a residential care home (RCH), and how well-being can be supported in gerontological social work and care at the RCH. Based on empirical data consisting of well-being narratives with elderly residents (average age of 91), a dialogical performance analysis was undertaken about their experiences of well-being at the RCH. The findings of importance are reported through three themes: (1) childhood memories as a source of well-being, (2) family and work as a source of well-being, and (3) opportunities for the well-being of the elderly at the RCH. To be an individual with others is a phenomenon of a personal sense of self and a phenomenon of sociality. Well-being is also found in the individual’s self-renewal. Well-being is about a sense of both individual continuity and change. Well-being is created in social situations with others (including caregivers) in daily interactions and in human contacts at the RCH. This kind of individual self-renewal is about human growth and is a human need regardless of age. Consequently, the human growth in (and despite) old age at RCH should be the main target of gerontological social work and care.

العلاقة: https://mts.intechopen.com/articles/show/title/well-being-in-old-age-a-question-of-both-continuity-and-changeTest

الإتاحة: https://doi.org/10.5772/intechopen.68680Test
https://mts.intechopen.com/articles/show/title/well-being-in-old-age-a-question-of-both-continuity-and-changeTest

المؤلفون: Swedish National Diabetes Register, Steineck, Isabelle, Cederholm, Jan, Eliasson, Björn, Rawshani, Araz, Eeg-Olofsson, Katarina, Svensson, Ann-Marie, Zethelius, Björn, Avdic, Tarik, Landin-Olsson, Mona, Jendle, Johan, Gudbjörnsdóttir, Soffia

المصدر: BMJ: British Medical Journal, 2015 Jun . 350

الوصول الحر: https://www.jstor.org/stable/26522059Test

المؤلفون: Prigge, Regina, McKnight, John A, Wild, Sarah H, Haynes, Aveni, Jones, Timothy W, Davis, Elizabeth A, Rami-Merhar, Birgit, Fritsch, Maria, Prchla, Christine, Lavens, Astrid, Doggen, Kris, Chao, Suchsia, Aronson, Ronnie, Brown, Ruth, Ibfelt, Else H, Svensson, Jannet, Young, Robert, Warner, Justin T, Robinson, Holy, Laatikainen, Tiina, Rautiainen, Päivi, Delemer, Brigitte, Souchon, Pierre François, Diallo, Alpha M, Holl, Reinhard W, Schmid, Sebastian M, Raile, Klemens, Tigas, Stelios, Bargiota, Alexandra, Zografou, Ioanna, Luk, Andrea O Y, Chan, Juliana C N, Dinneen, Sean F, Buckley, Claire M, Kgosidialwa, Oratile, Cherubini, Valentino, Gesuita, Rosaria, Strele, Ieva, Pildava, Santa, Veeze, Henk, Aanstoot, Henk-Jan, Mul, Dick, Jefferies, Craig, Cooper, John G, Løvaas, Karianne Fjeld, Battelino, Tadej, Dovc, Klemen, Bratina, Nataša, Eeg-Olofsson, Katarina, Svensson, Ann-Marie, Gudbjornsdottir, Soffia, Globa, Evgenia, Zelinska, Nataliya

المساهمون: Prigge, Regina, Mcknight, John A, Wild, Sarah H, Haynes, Aveni, Jones, Timothy W, Davis, Elizabeth A, Rami-Merhar, Birgit, Fritsch, Maria, Prchla, Christine, Lavens, Astrid, Doggen, Kri, Chao, Suchsia, Aronson, Ronnie, Brown, Ruth, Ibfelt, Else H, Svensson, Jannet, Young, Robert, Warner, Justin T, Robinson, Holy, Laatikainen, Tiina, Rautiainen, Päivi, Delemer, Brigitte, Souchon, Pierre Françoi, Diallo, Alpha M, Holl, Reinhard W, Schmid, Sebastian M, Raile, Klemen, Tigas, Stelio, Bargiota, Alexandra, Zografou, Ioanna, Luk, Andrea O Y, Chan, Juliana C N, Dinneen, Sean F, Buckley, Claire M, Kgosidialwa, Oratile, Cherubini, Valentino, Gesuita, Rosaria, Strele, Ieva, Pildava, Santa, Veeze, Henk, Aanstoot, Henk-Jan, Mul, Dick, Jefferies, Craig, Cooper, John G, Løvaas, Karianne Fjeld, Battelino, Tadej, Dovc, Klemen, Bratina, Nataša, Eeg-Olofsson, Katarina, Svensson, Ann-Marie, Gudbjornsdottir, Soffia, Globa, Evgenia, Zelinska, Nataliya

مصطلحات موضوعية: HbA1c, glycaemic control, registers of people with diabete, type 1 diabete, Adult, Blood Glucose, Child, Cross-Sectional Studie, Female, Glycated Hemoglobin A, Glycemic Control, Human, Male, Diabetes Mellitus, Type 1

الوصف: To update and extend a previous cross-sectional international comparison of glycaemic control in people with type 1 diabetes.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/34890078; info:eu-repo/semantics/altIdentifier/wos/WOS:000734358300001; volume:39; issue:5; journal:DIABETIC MEDICINE; https://hdl.handle.net/11566/307608Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85128493437

الإتاحة: https://doi.org/10.1111/dme.14766Test
https://hdl.handle.net/11566/307608Test

المؤلفون: Charalampopoulos, Dimitrios, Hermann, Julia M, Svensson, Jannet, Skrivarhaug, Torild, Maahs, David M, Akesson, Karin, Warner, Justin T, Holl, Reinhard W, Birkebæk, Niels H, Drivvoll, Ann K, Miller, Kellee M, Svensson, Ann-Marie, Stephenson, Terence, Hofer, Sabine E, Fredheim, Siri, Kummernes, Siv J, Foster, Nicole, Hanberger, Lena, Amin, Rakesh, Rami-Merhar, Birgit, Johansen, Anders, Dahl-Jørgensen, Knut, Clements, Mark, Hanas, Ragnar

المصدر: Charalampopoulos , D , Hermann , J M , Svensson , J , Skrivarhaug , T , Maahs , D M , Akesson , K , Warner , J T , Holl , R W , Birkebæk , N H , Drivvoll , A K , Miller , K M , Svensson , A-M , Stephenson , T , Hofer , S E , Fredheim , S , Kummernes , S J , Foster , N , Hanberger , L , Amin , R , Rami-Merhar , B , Johansen , A , Dahl-Jørgensen , K , Clements , ....

مصطلحات موضوعية: Adolescent, Austria/epidemiology, Blood Glucose/metabolism, Child, Cross-Sectional Studies, Denmark/epidemiology, Developed Countries/economics, Diabetes Mellitus, Type 1/blood, England/epidemiology, Female, Germany/epidemiology, Glycated Hemoglobin A/analysis, Humans, Income/statistics & numerical data, Male, Minority Groups/statistics & numerical data, Norway/epidemiology, Sweden/epidemiology, Wales/epidemiology

الوصف: OBJECTIVE: International studies on childhood type 1 diabetes (T1D) have focused on whole-country mean HbA1c levels, thereby concealing potential variations within countries. We aimed to explore the variations in HbA1c across and within eight high-income countries to best inform international benchmarking and policy recommendations. RESEARCH DESIGN AND METHODS: Data were collected between 2013 and 2014 from 64,666 children with T1D who were <18 years of age across 528 centers in Germany, Austria, England, Wales, US, Sweden, Denmark, and Norway. We used fixed and random-effects models adjusted for age, sex, diabetes duration, and minority status to describe differences between center means and to calculate the proportion of total variation in HbA1c levels that is attributable to between-center differences (intraclass correlation [ICC]). We also explored the association between within-center variation and children's glycemic control. RESULTS: Sweden had the lowest mean HbA1c (59 mmol/mol [7.6%]) and together with Norway and Denmark showed the lowest between-center variations (ICC ≤ 4%). Germany and Austria had the next lowest mean HbA1c (61-62 mmol/mol [7.7-7.8%]) but showed the largest center variations (ICC ∼15%). Centers in England, Wales, and the US showed low-to-moderate variation around high mean values. In pooled analysis, differences between counties remained significant after adjustment for children characteristics and center effects (P value <0.001). Across all countries, children attending centers with more variable glycemic results had higher HbA1c levels (5.6 mmol/mol [0.5%] per 5 mmol/mol [0.5%] increase in center HbA1c SD). CONCLUSIONS: At similar average levels of HbA1c, countries display different levels of center variation. The distribution of glycemic achievement within countries should be considered in developing informed policies that drive quality improvement.

العلاقة: https://pure.au.dk/portal/en/publications/de9b717f-090d-4b43-8bec-68e2226e7067Test

الإتاحة: https://doi.org/10.2337/dc17-2271Test
https://pure.au.dk/portal/en/publications/de9b717f-090d-4b43-8bec-68e2226e7067Test
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5961394/pdf/dc172271.pdfTest