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  • 1. Andersson, P O
    et al.
    Wikby, Anders
    Jönköping University, School of Health Science, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Hörnquist, J O
    Influence of insulin pen injection frequency on quality of life1990In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 13, no 11, p. 1135-1136Article in journal (Refereed)
  • 2. Johannesson, Anton
    et al.
    Larsson, Gert-Uno
    Ramstrand, Nerrolyn
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Prosthetics and Orthotics.
    Turkiewicz, Aleksandra
    Wiréhn, Ann-Britt
    Atroshi, Isam
    Incidence of Lower Limb Amputation in the Diabetic and Nondiabetic General Population: A 10-year population-based cohort study of initial unilateral and contralateral amputations and reamputations2009In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 32, no 2, p. 275-280Article in journal (Refereed)
    Abstract [en]

    Objective: To compare the incidence of vascular lower limb amputation (LLA) in the diabetic and nondiabetic general population. Research design & methods: A population-based cohort study was conducted in a representative Swedish region. All vascular LLA (at or proximal to transmetatarsal level) performed from 1997 through 2006 were consecutively registered and classified into initial unilateral amputation, contralateral amputation or re-amputation. The incidence rates were estimated in the diabetic and nondiabetic general population aged 45 years or older. Results: During the 10-year period, LLA was performed on 62 women and 71 men with diabetes and on 79 women and 78 men without diabetes. The incidence of initial unilateral amputation per 100,000 person-years (95% CI) was for diabetic women 192 (145-241) and for diabetic men 197 (152-244) and for nondiabetic women 22 (17-26) and for nondiabetic men 24 (19-29). The incidence increased from the age of 75 years. 74% of all amputations were transtibial. The incidence of contralateral amputation and of re-amputation per 100 amputee-years (95% CI) in diabetic women amputees was 15 (7-27) and 16 (8-28) and in diabetic men 18 (10-29) and 21 (12-32), respectively, and in nondiabetic women amputees were 14 (7-24) and 18 (10-28) and in men 13 (6-22) and 24 (15-35), respectively. Conclusions: In the general population aged 45 years or older the incidence of vascular lower limb amputation at or proximal to transmetatarsal level is 8 times higher in diabetic than in nondiabetic persons. One in four amputees may require contralateral amputation and/or re-amputation.

  • 3. Nyberg, Solja T
    et al.
    Fransson, Eleonor I
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Heikkilä, Katriina
    Ahola, Kirsi
    Alfredsson, Lars
    Bjorner, Jakob B
    Borritz, Marianne
    Burr, Hermann
    Dragano, Nico
    Goldberg, Marcel
    Hamer, Mark
    Jokela, Markus
    Knutsson, Anders
    Koskenvuo, Markku
    Koskinen, Aki
    Kouvonen, Anne
    Leineweber, Constanze
    Madsen, Ida E H
    Magnusson Hanson, Linda L
    Marmot, Michael G
    Nielsen, Martin L
    Nordin, Maria
    Oksanen, Tuula
    Pejtersen, Jan H
    Pentti, Jaana
    Rugulies, Reiner
    Salo, Paula
    Siegrist, Johannes
    Steptoe, Andrew
    Suominen, Sakari
    Theorell, Töres
    Väänänen, Ari
    Vahtera, Jussi
    Virtanen, Marianna
    Westerholm, Peter J M
    Westerlund, Hugo
    Zins, Marie
    Batty, G David
    Brunner, Eric J
    Ferrie, Jane E
    Singh-Manoux, Archana
    Kivimäki, Mika
    Job strain as a risk factor for type 2 diabetes: a pooled analysis of 124,808 men and women2014In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 37, no 8, p. 2268-2275Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The status of psychosocial stress at work as a risk factor for type 2 diabetes is unclear because existing evidence is based on small studies and is subject to confounding by lifestyle factors, such as obesity and physical inactivity. This collaborative study examined whether stress at work, defined as "job strain," is associated with incident type 2 diabetes independent of lifestyle factors.

    RESEARCH DESIGN AND METHODS: We extracted individual-level data for 124,808 diabetes-free adults from 13 European cohort studies participating in the IPD-Work Consortium. We measured job strain with baseline questionnaires. Incident type 2 diabetes at follow-up was ascertained using national health registers, clinical screening, and self-reports. We analyzed data for each study using Cox regression and pooled the study-specific estimates in fixed-effect meta-analyses.

    RESULTS: There were 3,703 cases of incident diabetes during a mean follow-up of 10.3 years. After adjustment for age, sex, and socioeconomic status (SES), the hazard ratio (HR) for job strain compared with no job strain was 1.15 (95% CI 1.06-1.25) with no difference between men and women (1.19 [1.06-1.34] and 1.13 [1.00-1.28], respectively). In stratified analyses, job strain was associated with an increased risk of diabetes among those with healthy and unhealthy lifestyle habits. In a multivariable model adjusted for age, sex, SES, and lifestyle habits, the HR was 1.11 (1.00-1.23).

    CONCLUSIONS: Findings from a large pan-European dataset suggest that job strain is a risk factor for type 2 diabetes in men and women independent of lifestyle factors.

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