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Algengi sykursýki af tegund tvö á Íslandi 1967-2002

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Authors
Jóhannes Bergsveinsson
Thor Aspelund
Vilmundur Guðnason
Rafn Benediktsson
Issue Date
2007-05-01

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Other Titles
Prevalence of type 2 diabetes mellitus in Iceland 1967-2002
Citation
Læknablaðið 2007, 93(5):397-402
Abstract
BACKGROUND AND AIMS: The prevalence of type 2 diabetes (T2DM) is increasing at an alarming rate worldwide. The prevalence of T2DM in Iceland has been comparatively low. The aim of this study is to estimate the prevalence of T2DM in Iceland from 1967-2002 using American Diabetic Association (ADA) '97 criteria and to assess the effect of employing three different diagnostic criteria: World Health Organization (WHO) '85, ADA'97, WHO'99. MATERIALS AND METHODS: This study is based on data from the Icelandic Heart Association (IHA), mostly from a representative random sample of the Icelandic population (The Reykjavik Study). The total population of this survey is 16393, 7852 males and 8541 females, aged 45-64. The study period was divided into five equal size cross-sectional periods, each about 6 years. The prevalence of T2DM was computed for every period. RESULTS: The age-standardized prevalence (95% CI) of T2DM in males, computed according to ADA'97 criteria has in a 30 year period risen from 3.3% (2.6-4.0) to 4.9% (3.5-5.3) which is an increase of 48%. In females the prevalence rose from 1.9% (1.4-2.4) to 2.9% (1.9-3.9) in the same period, a 53% increase. The Ratio of unknown T2DM is 0.66. Prevalence of T2DM in obese males and females is 10.6% (95% CI: 8.6-12.6) and 7.1% (95% CI: 5.5-8.7) respectively. CONCLUSION: The prevalence of T2DM is now increasing in Iceland as in the rest of the world although the increase has taken place somewhat later than elsewhere. The prevalence of T2DM is however still relatively low when compared to other western countries. Early detection of T2DM is of importance and screening should be used according to clinical guidelines. The current increase in T2DM is most likely due to increasing obesity.
Inngangur: Algengi sykursýki af tegund 2 hefur aukist gríðarlega en á síðustu árum hafa verið lögð til ný og mismunandi greiningarskilmerki fyrir sykursýki sem leitt hefur til ósamræmis hvað algengistölur varðar. Tilgangur þessarar rannsóknar er að meta algengi sjúkdómsins á Íslandi á tímabilinu 1967-2002 með greiningarskilmerkjum American Diabetic Association (ADA) ´97. Einnig að bera saman þjú mismunandi greiningarskilmerki: World Health Organization (WHO) ´85, ADA´97, WHO´99. Efniviður og aðferðir: Notuð voru gögn úr þremur rannsóknum Hjartaverndar: Hóprannsókn Hjartaverndar, Afkomendarannsókn og Rannsókn á ungu fólki, alls 16393 einstaklingar, 7852 karlar og 8541 konur. Skoðað var aldursbilið 45-64 ára. Rannsóknartímabilinu var skipt niður í fimm þversniðstímabil og var algengið metið á hverju tímabili. Niðurstöður: Aldursstaðlað algengi (95% öryggismörk) sykursýki samkvæmt ADA´97 hefur á 30 ára tímabili vaxið úr 3,3% (2,6-4,0) í 4,9% (3,5-5,3) hjá körlum sem er um 48% hækkun og úr 1,9% (1,4-2,4) í 2,9% (1,9-3,9) hjá konum á sama aldri eða um 53% hækkun. Fyrir hvern einn sem er með þekkta sykursýki eru nú um tveir með óþekkta sykursýki. Greiningarskilmerki WHO´99 hafa mesta næmið. Algengi hjá þeim sem teljast of feitir er 10,6% (95% CI: 8,6-12,6) hjá körlum og 7,1% (95% CI: 5,5-8,7) hjá konum. Ályktun: Ljóst er að sama þróun á sér stað hérlendis og annars staðar hvað varðar aukningu en þó er algengi hér með því lægsta sem þekkist í Evrópu. Þörf er á að fylgja klínískum leiðbeiningum og beita skimun í skilgreindum áhættuhópum, sérstaklega þeim sem eiga við offituvandamál að stríða. Líklega er það vaxandi hlutfall ofþyngdar og offitu sem stuðlar hvað mest að auknu algengi.
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