Epidemiological studies of childhood diabetes and important health complications to the disease
نویسنده
چکیده
iii Populärvetenskaplig sammanfattning v Original Papers vii Introduction 1 Historical overview 1 Criteria for diagnosis of diabetes 4 Background to this thesis 5 Type 1-diabetes in childhood 5 Etiology 6 Genetic predisposition 7 Environmental risk factors 7 Type-2 diabetes in childhood 9 Diabetes related health complications 10 Renal disease in T1D patients 11 Mortality in T1D patients 13 Aim 15 Study populations 16 Summary of study populations and registers 16 Description of the study populations and the nationwide registers 16 The Swedish Childhood Diabetes Registry (SCDR) 16 The population screened for T2D 17 The Diabetes Incidence Study in Sweden (DISS) 18 The Cause of Death Register (CDR) 18 The Swedish Renal Registry (SRR) 18 The Longitudinal Integration Database for Health Insurance and Labor Market Studies (LISA) 19 Ethical considerations 19 Methods 20 Time trend of childhood onset type-1 diabetes (Paper I) 20 Generalized additive models 20 Cohort analyses 21 Type-2 diabetes in children (Paper II) 21 Screening for children with increased risk of T2D 21 Screening for undetected T2D 22 ESRD in young patients with type-1 diabetes (Paper III) 22 Assessing the effects of sex and age at-onset of T1D on the cumulative incidence and long-term risk of ESRD 22 Basic concepts of competing risks in survival analysis 23 Mortality and impact of socioeconomic status (Paper IV) 23 Definition of the SES measures 24 Assessing the effect of parental and individual SES on mortality 24 Statistical analysis 26 Major findings 27 ii Time trend of childhood onset type-1 diabetes (Paper I) 27 Describing the time-trend 27 Analyzing the cumulative incidence 28 Type-2 diabetes in children (Paper II) 30 ESRD in young patients with type-1 diabetes (Paper III) 31 Mortality and impact of socioeconomic status (Paper IV) 32 Discussion of major findings 34 Time trend of childhood onset type-1 diabetes (Paper I) 34 T1D incidence among Swedish children is higher than ever 34 An accelerating increase of T1D in the light of childhood obesity 34 A shift to younger age at-onset due to life style factors? 35 A reversed trend 35 A reversed trend due to life style changes? 35 Type-2 diabetes in children (Paper II) 36 Should we worry about T2D in Swedish children? 36 Should we worry about T2D in Swedish adolescents? 37 ESRD in young patients with type-1 diabetes (Paper III) 38 Diabetic nephropathy, " then and now " 38 The age and sex specific differences 39 The …
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