SAGE Journals Online
Advertisement
Sign In to gain access to subscriptions and/or personal tools.

 

Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

Advertisement

Sign In to gain access to subscriptions and/or personal tools.
Scandinavian Journal of Public Health
This Article
Right arrow Abstract Freely available
Right arrow Free Full Text (Free PDF) Free
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Eliasson, M.
Right arrow Articles by Stegmayr, B.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Eliasson, M.
Right arrow Articles by Stegmayr, B.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Diabetes and obesity in Northern Sweden: occurrence and risk factors for stroke and myocardial infarction

Mats Eliasson

Department of Medicine, Sunderby Hospital, LuleÅ, Sweden, mats.eliasson{at}nll.se, Medicine, Department of Public Health and Clinical Medicine, UmeÅ University, UmeÅ, Sweden

Bernt Lindahl

Behavioral Medicine, Department of Public Health and Clinical Medicine, UmeÅ University

Vivan Lundberg

Department of Internal Medicine, Kalix Hospital, Kalix, Sweden

Birgitta Stegmayr

Medicine, Department of Public Health and Clinical Medicine, UmeÅ University, UmeÅ, Sweden

Aims: The authors describe the occurrence of diabetes and obesity in the population of Northern Sweden and the role of diabetes in cardiovascular disease. Methods: Four surveys of the population aged 25 to 64 years were undertaken during a 14-year time span. Stroke events in subjects 35 - 74 years during 1985 - 92 and myocardial infarction in subjects 25 - 64 years 1989 - 93 were registered. Results: The prevalence of diagnosed diabetes was 3.1 and 2.0% in men and women, respectively, and 2.6 and 2.7% for previously undiagnosed diabetes. During the 13-year observation period, BMI increased 0.96 kg/m2 in men and 0.87 in women. The proportion of subjects with obesity (BMI≥30) increased from 10.3% to 14.6% in men and from 12.5% to 15.7% in women. Hip circumference increased substantially more than waist circumference, leading to a decreasing waits-to-hip ratio (WHR). The relative risk for stroke or myocardial infarction was four to six times higher in a person with diabetes than in those without diabetes. The 28-day case fatality for myocardial infarction, but not for stroke, was significantly higher in both men and women with diabetes. Population-attributable risk for diabetes and stroke was 18% in men and 22% in women and for myocardial infarction it was 11% in men and 17% in women. Conclusion: Obesity is becoming more common, although of a more distal than central distribution. The burden of diabetes in cardiovascular diseases in Northern Sweden is high.

Key Words: diabetes mellitus • myocardial infarction • obesity • prevalence • stroke • time trends • women.

References

  • Henriksson F., Jönsson B. Diabetes: the cost of illness in Sweden. J Intern Med 1998; 244: 461 - 8.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Henriksson F., Agardh CD, Berne C., Bolinder J., Lonnqvist F., Stenstrom P., et al. Direct medical costs for patients with type 2 diabetes in Sweden. J Intern Med 2000; 248: 387 - 96.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Willett WC, Dietz WH, Colditz GA Guidelines for healthy weight. N Engl J Med 1999; 341: 427 - 34.[Free Full Text]
  • Field AE, Coakley EH, Must A., Spadano JL, Laird N., Dietz WH, et al. Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Arch Intern Med 2001; 161: 1581 - 6.[Abstract/Free Full Text]
  • Seidell JC Time trends in obesity: an epidemiological perspective. Horm Metab Res 1997; 29: 155 - 8.[Web of Science][Medline] [Order article via Infotrieve]
  • Kuczmarski RJ, Flegal KM, Campbell SM, Johnson CL Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960 to 1991. JAMA 1994; 272: 205 - 11.[Abstract/Free Full Text]
  • Midthjell K., Kruger O., Holmen J., Tverdal A., Claudi T., Bjorndal A., et al. Rapid changes in the prevalence of obesity and known diabetes in an adult Norwegian population. The Nord-Trondelag Health Surveys: 1984 - 1986 and 1995-1997. Diabetes Care 1999; 22: 1813 - 20.[Abstract/Free Full Text]
  • Laakso M., Reunanen A., Klaukka T., Aromaa A., Maatela J., Pyörälä K. Changes in the prevalence and incidence of diabetes mellitus in Finnish adults, 1970 - 1987. Am J Epidemiol 1991; 133: 850 - 7.[Abstract/Free Full Text]
  • Drivsholm T., Ibsen H., Schroll M., Davidsen M., Borch-Johnsen K. Increasing prevalence of diabetes mellitus and impaired glucose tolerance among 60-year-old Danes. Diabet Med 2001; 18: 126 - 32.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Lissner L., Johansson SE, Qvist J., Rossner S., Wolk A. Social mapping of the obesity epidemic in Sweden. Int J Obes Relat Metab Disord 2000; 24: 801 - 5.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Fuller JH, Shipley MJ, Rose G., Jarrett RJ, Keen H. Mortality from coronary heart disease and stroke in relation to degree of glycaemia: the Whitehall study. Br Med J (Clin Res Ed) 1983; 287: 867 - 70.[Medline] [Order article via Infotrieve]
  • Kannel WB, McGee DL Diabetes and cardiovascular disease. The Framingham study. JAMA 1979; 241: 2035 - 8.[Abstract/Free Full Text]
  • Abbott RD, Donahue RP, MacMahon SW, Reed DM, Yano K. Diabetes and the risk of stroke. The Honolulu Heart Program. JAMA 1987; 257: 949 - 52.[Abstract/Free Full Text]
  • Adams HP, Jr, Putman SF, Kassell NF, Torner JC Prevalence of diabetes mellitus among patients with subarachnoid hemorrhage. Arch Neurol 1984; 41: 1033 - 5.[Abstract/Free Full Text]
  • Jamrozik K., Broadhurst RJ, Anderson CS, Stewart-Wynne EG The role of lifestyle factors in the etiology of stroke. A population-based case-control study in Perth, Western Australia. Stroke 1994; 25: 51 - 9.[Abstract]
  • Barrett-Connor E., Khaw KT Diabetes mellitus: an independent risk factor for stroke? Am J Epidemiol 1988; 128: 116 - 23.[Abstract/Free Full Text]
  • Asplund K., Hagg E., Helmers C., Lithner F., Strand T., Wester PO The natural history of stroke in diabetic patients. Acta Med Scand 1980; 207: 417 - 24.[Web of Science][Medline] [Order article via Infotrieve]
  • Olsson T., Viitanen M., Asplund K., Eriksson S., Hagg E. Prognosis after stroke in diabetic patients. A controlled prospective study. Diabetologia 1990; 33: 244 - 9.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Stegmayr B., Asplund K. Diabetes as a risk factor for stroke. A population perspective. Diabetologia 1995; 38: 1061 - 8.[Web of Science][Medline] [Order article via Infotrieve]
  • Lundberg V., Stegmayr B., Asplund K., Eliasson M., Huhtasaari F. Diabetes as a risk factor for myocardial infarction: population and gender perspectives. J Intern Med 1997; 241: 485 - 92.[Web of Science][Medline] [Order article via Infotrieve]
  • Stegmayr B., Lundberg V., Asplund K. The event registration and survey procedures in the Northern Sweden MONICA project. Scand J Publ Health, Suppl. 61.
  • World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications. Report of a WHO consultation, Part 1: Diagnosis and classification of diabetes mellitus. Geneva: WHO/NCD/ NCS/99.2, 1999.
  • Isacson D., Stalhammar J. Prescription drug use among diabetics - a population study. J Chronic Dis 1987; 40: 651 - 60.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Falkenberg MG Diabetes mellitus: prevalence and local risk factors in a primary health care district. Scand J Soc Med 1987; 15: 139 - 44.[Web of Science][Medline] [Order article via Infotrieve]
  • Lundman B., Engström L. Diabetes and its complications in a Swedish county. Diabetes Res Clin Pract 1998; 39: 157 - 64.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Lindahl B., Weinehall L., Asplund K., Hallmans G. Screening for impaired glucose tolerance. Results from a population-based study in 21,057 individuals. Diabetes Care 1999; 22: 1988-92.[Abstract/Free Full Text]
  • Lindahl B. Lifestyle and health. The role of insulin resistance syndrome in cardiovascular disease and diabetes. The effects of lifestyle intervention (thesis). Umeå: Umeå University, 1998.
  • Harris MI, Flegal KM, Cowie CC, Eberhardt MS, Goldstein DE, Little RR, et al. Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in US adults. The Third National Health and Nutrition Examination Survey, 1988 - 1994. Diabetes Care 1998; 21: 518 - 24.[Abstract]
  • Ohlson LO, Larsson B., Eriksson H., Svärdsudd K., Welin L., Tibblin G. Diabetes mellitus in Swedish middle-aged men. The study of men born in 1913 and 1923. Diabetologia 1987; 30: 386 - 93.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Andersson DK, Svärdsudd K., Tibblin G. Prevalence and incidence of diabetes in a Swedish community 1972 - 1987. Diabet Med 1991; 8: 428 - 34.[Web of Science][Medline] [Order article via Infotrieve]
  • Molarius A., Seidell JC, Sans S., Tuomilehto J., Kuulasmaa K. Waist and hip circumferences, and waist - hip ratio in 19 populations of the WHO MONICA Project. Int J Obes Relat Metab Disord 1999; 23: 116 - 25.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Wilhelmsen L., Johansson S., Rosengren A., Wallin I., Dotevall A., Lappas G. Risk factors for cardiovascular disease during the period 1985 - 1995 in Goteborg, Sweden. The GOT-MONICA Project. J Intern Med 1997; 242: 199 - 211.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Lissner L., Bjorkelund C., Heitmann BL, Lapidus L., Bjorntorp P., Bengtsson C. Secular increases in waist-hip ratio among Swedish women. Int J Obes Relat Metab Disord 1998; 22: 1116-20.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Lindahl B., Stegmayr B., Johansson I., Weinehall L., Hallmans G. Trends in lifestyle 1986 - 1999 in a 25- to 64-year-old population of the Northern Sweden MONICA project. Scand J Publ Health, Suppl. 61.
  • Ohlson LO, Larsson B., Svärdsudd K., Welin L., Eriksson H., Wilhelmsen L., et al. The influence of body fat distribution on the incidence of diabetes mellitus. 13.5 years of follow-up of the participants in the study of men born in 1913. Diabetes 1985; 34: 1055 - 8.[Abstract]
  • Lundgren H., Bengtsson C., Blohme G., Lapidus L., Sjöström L. Adiposity and adipose tissue distribution in relation to incidence of diabetes in women: results from a prospective population study in Gothenburg, Sweden. Int J Obes 1989; 13: 413 - 23.[Web of Science][Medline] [Order article via Infotrieve]
  • Eliasson M., Lindahl B., Lundberg V., Stegmayr B. No increase in the prevalence of known diabetes between 1986 and 1999 in subjects 25 - 64 years of age in northern Sweden. Diabetic Med 2002; 19: 874 - 80.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet 1998; 352: 837 - 53.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group. Br Med J 1998; 317: 703 - 13.[Abstract/Free Full Text]
  • Haffner SM, Lehto S., Ronnemaa T., Pyorala K., Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 1998; 339: 229 - 34.[Abstract/Free Full Text]
  • Hu FB, Stampfer MJ, Solomon CG, Liu S., Willett WC, Speizer FE, et al. The impact of diabetes mellitus on mortality from all causes and coronary heart disease in women: 20 years of follow-up. Arch Intern Med 2001; 161: 1717-23.[Abstract/Free Full Text]
  • Tuomilehto J., Lindstrom J., Eriksson JG, Valle TT, Hamalainen H., Ilanne-Parikka P., et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344: 1343 - 50.[Abstract/Free Full Text]

Scandinavian Journal of Public Health, Vol. 31, No. 61 suppl, 70-77 (2003)
DOI: 10.1080/14034950310001360
Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?



This Article
Right arrow Abstract Freely available
Right arrow Free Full Text (Free PDF) Free
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Eliasson, M.
Right arrow Articles by Stegmayr, B.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Eliasson, M.
Right arrow Articles by Stegmayr, B.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Advertisement