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Author (up) Fleiner, H.F.; Bjoro, T.; Midthjell, K.; Grill, V.; Asvold, B.O. url  doi
  Title Prevalence of Thyroid Dysfunction in Autoimmune and Type 2 Diabetes: The Population-Based HUNT Study in Norway Type Journal Article
  Year 2016 Publication J Clin Endocrinol Metab Abbreviated Journal The Journal of clinical endocrinology and metabolism  
  Volume 101 Issue 2 Pages 669-677  
  Keywords Adult; Age of Onset; Aged; Cross-Sectional Studies; Databases, Factual; Diabetes Mellitus, Type 1/*complications/*epidemiology; Diabetes Mellitus, Type 2/*complications/*epidemiology; Female; Humans; Hyperthyroidism/complications/epidemiology; Hypothyroidism/complications/epidemiology; Iodide Peroxidase/blood/immunology; Male; Middle Aged; Norway/epidemiology; Prevalence; Sex Factors; Thyroid Diseases/*complications/*epidemiology; Thyroid Hormones/blood  
  Abstract CONTEXT: Associations between autoimmune diabetes and autoimmune thyroid disease are known but insufficiently characterized. Some evidence suggests that type 2 diabetes may also be associated with hypothyroidism. OBJECTIVE: The objective of the study was to investigate associations of autoimmune and type 2 diabetes with the prevalence of hypo- and hyperthyroidism. DESIGN AND SETTING: This was a cross-sectional, population-based study of adults in two surveys of the Nord-Trondelag Health (HUNT) Study. PARTICIPANTS: A total of 34 235 participants of HUNT2 (1995-1997) and 48 809 participants of HUNT3 (2006-2008) participated in the study. MAIN OUTCOME MEASURES: Prevalence of hypo- and hyperthyroidism was estimated, assessed by self-report, serum measurements, and linkage with the Norwegian Prescription Database. RESULTS: In HUNT2, autoimmune diabetes was associated with a higher age-adjusted prevalence of hypothyroidism among both women (prevalence ratio 1.79, 95% confidence interval [CI] 1.30-2.47) and men (prevalence ratio 2.71, 95% CI 1.76-4.19), compared with having no diabetes. For hyperthyroidism, the corresponding cumulative prevalence ratios were 2.12 (95% CI 1.36-3.32) in women and 2.54 (95% CI 1.24-5.18) in men with autoimmune diabetes. The age-adjusted excess prevalence of hypothyroidism ( approximately 6 percentage points) and the presence of thyroid peroxidase antibodies (8-10 percentage points) associated with autoimmune diabetes was similar in women and men. Type 2 diabetes was not associated with the prevalence of hypothyroidism. In HUNT3, associations were broadly similar to those in HUNT2. CONCLUSIONS: Autoimmune diabetes, but not type 2 diabetes, was strongly and gender neutrally associated with an increased prevalence of hypo- and hyperthyroidism and the presence of thyroid peroxidase antibodies. Increased surveillance for hypothyroidism appears not necessary in patients with type 2 diabetes.  
  Address  
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  Publisher Place of Publication Department of Cancer Research and Molecular Medicine (H.F.F., V.G.), Norwegian University of Science Editor  
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  Notes Fleiner, Hanne FBjoro, TrineMidthjell, KristianGrill, ValdemarAsvold, Bjorn OengResearch Support, Non-U.S. Gov't2015/11/20 06:00J Clin Endocrinol Metab. 2016 Feb;101(2):669-77. doi: 10.1210/jc.2015-3235. Epub 2015 Nov 19. Approved no  
  Call Number HUNT @ maria.stuifbergen @ Fleiner2016 Serial 1738  
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Author (up) Iversen, M.M.; Nefs, G.; Tell, G.S.; Espehaug, B.; Midthjell, K.; Graue, M.; Pouwer, F. url  doi
  Title Anxiety, depression and timing of insulin treatment among people with type 2 diabetes: Nine-year follow-up of the Nord-Trondelag Health Study, Norway Type Journal Article
  Year 2015 Publication J Psychosom Res Abbreviated Journal Journal of psychosomatic research  
  Volume 79 Issue 4 Pages 309-315  
  Keywords HUNT2; Adult; Aged; Aged, 80 and over; Anxiety/*etiology; Cohort Studies; Depression/diagnosis/*etiology; Diabetes Mellitus, Type 2/*complications/drug therapy; Female; Humans; Insulin/administration & dosage/*therapeutic use; Male; Middle Aged; Norway; Prospective Studies; Young Adult  
  Abstract BACKGROUND: Depression and anxiety have been found to be predictors of poor health outcomes in diabetes, but mechanisms are still unclear. AIMS: To examine whether symptoms of anxiety and depression were associated with timing of initiating insulin therapy. METHODS: A cohort study of insulin-naive particpants with type 2 dabetes completed the Hospital Anxiey and Depression Scale, HADS-A (n = 731) and/or the HADS-D (n = 768) in the communy-based Nord-Trondelag Health Study (1995-1997). Information on insulin initiation was retrieved from the Norwegian Prescription Database from January 1, 2004 to November 21, 2012. Cox regression analyses were used to estimate the association between symptoms of anxiety, depression and time to insulin initiation. RESULTS: At baseline, 19% reported anxiety symptoms (score>/=8) and 18% depressive symptoms (score>/=8). After a mean follow-up of 4.4 (SD 3.6) years, 337 (40%) participants had started insulin therapy. After adjustment for sociodemographic and clinical variables, anxiety symptoms were associated with later initiation of insulin therapy (HR 0.70, 95% CI 0.49-0.99), while depressive symptoms were not. Considering groups simultaneously, having both elevated depressive and elevated anxiety symptoms was associated with later time to insulin initiation (HR 0.62, 95% CI 0.39-0.99), while having only anxiety symptoms (without depressive) HR 0.81, 95% CI 0.50-1.32) or only depressive symptoms (without anxiety) (HR 1.08, 95% CI 0.68-1.72) were not. CONCLUSIONS: Anxiety was associated with a later initiation of insulin, while depressive symptoms were not. Persons with both elevated levels of anxiety and depression were also less likely to start insulin therapy. These results need further testing in other prospective studies.  
  Address  
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  Publisher Place of Publication Centre for Evidence-Based Practice, Bergen University College, Norway; Department of Endocrinology, Editor  
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  Notes Iversen, M MNefs, GTell, G SEspehaug, BMidthjell, KGraue, MPouwer, FengEngland2015/07/26 06:00J Psychosom Res. 2015 Oct;79(4):309-15. doi: 10.1016/j.jpsychores.2015.07.004. Epub 2015 Jul 16. Approved no  
  Call Number HUNT @ maria.stuifbergen @ Iversen2015b Serial 1825  
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Author (up) Naicker, K.; Johnson, J.A.; Skogen, J.C.; Manuel, D.; Overland, S.; Sivertsen, B.; Colman, I. url  doi
  Title Type 2 Diabetes and Comorbid Symptoms of Depression and Anxiety: Longitudinal Associations With Mortality Risk Type Journal Article
  Year 2017 Publication Diabetes Care Abbreviated Journal Diabetes Care  
  Volume 40 Issue 3 Pages 352-358  
  Keywords Adult; Aged; Aged, 80 and over; Anxiety/*complications; Comorbidity; Depression/*complications; Diabetes Mellitus, Type 2/*complications; Female; Follow-Up Studies; Humans; Male; Middle Aged; Norway/epidemiology; Proportional Hazards Models; Risk Factors; Socioeconomic Factors; Surveys and Questionnaires; Young Adult  
  Abstract OBJECTIVE: Depression is strongly linked to increased mortality in individuals with type 2 diabetes. Despite high rates of co-occurring anxiety and depression, the risk of death associated with comorbid anxiety in individuals with type 2 diabetes is poorly understood. This study documented the excess mortality risk associated with symptoms of depression and/or anxiety comorbid with type 2 diabetes. RESEARCH DESIGN AND METHODS: Using data for 64,177 Norwegian adults from the second wave of the Nord-Trondelag Health Study (HUNT2), with linkage to the Norwegian Causes of Death Registry, we assessed all-cause mortality from survey participation in 1995 through to 2013. We used Cox proportional hazards models to examine mortality risk over 18 years associated with type 2 diabetes status and the presence of comorbid affective symptoms at baseline. RESULTS: Three clear patterns emerged from our findings. First, mortality risk in individuals with diabetes increased in the presence of depression or anxiety, or both. Second, mortality risk was lowest for symptoms of anxiety, higher for comorbid depression-anxiety, and highest for depression. Lastly, excess mortality risk associated with depression and anxiety was observed in men with diabetes but not in women. The highest risk of death was observed in men with diabetes and symptoms of depression only (hazard ratio 3.47, 95% CI 1.96, 6.14). CONCLUSIONS: This study provides evidence that symptoms of anxiety affect mortality risk in individuals with type 2 diabetes independently of symptoms of depression, in addition to attenuating the relationship between depressive symptoms and mortality in these individuals.  
  Address School of Public Health and Preventive Medicine, University of Ottawa, Ontario, Canada icolman@uottawa.ca  
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  Language English Summary Language Original Title  
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  ISSN 0149-5992 ISBN Medium  
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  Notes PMID:28077458 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1961  
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