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dc.contributor.advisorJulsrud Berg, Tore
dc.contributor.authorSlåtsve, Kristina Barbara
dc.date.accessioned2022-09-08T10:55:24Z
dc.date.available2022-09-08T10:55:24Z
dc.date.issued2022-10-04
dc.description.abstractThe total prevalence of diabetes and vascular complications is increasing. Consequently, it is important to provide diabetes treatment according to the National clinical guideline for the management of diabetes and allocate individuals to the right level of health care in line with the National guideline for prioritization in specialist health care – Endocrinology and endocrine surgery. We used data from the Rogaland-Oslo-Salten-Akershus-Hordaland study (ROSA 4) and The Norwegian Diabetes Register for Adults to study the prevalence of diagnosed type 2 and type 1 diabetes and the status of diabetes treatment in Salten, Norway. Moreover, we studied the association between education level and vascular complications in individuals with type 2 diabetes born in Norway. The results showed that the total diabetes prevalence in Salten in all age groups was 3.8%. The prevalence of type 2 diabetes was 3.4%, and the prevalence of type 1 diabetes was 0.45%. Coronary heart disease was more prevalent in individuals with type 2 diabetes than in those with type 1 diabetes (23.1% vs 15.8%). The HbA1c treatment target of ≤ 53 mmol/mol (≤ 7.0%) was reached by 61.1% of individuals with type 2 diabetes and 22.5% of individuals with type 1 diabetes, and by 67.3% and 30.4% of individuals with type 2 diabetes treated in primary care and specialist/shared care, respectively. In individuals with type 2 diabetes, higher HbA1c levels, insulin-use, coronary heart disease, retinopathy, and general practitioners’ urban location were positively associated with treatment in specialist care. Higher education was associated with lower odds for coronary heart disease and chronic kidney disease compared to compulsory education in individuals with type 2 diabetes born in Norway.en_US
dc.description.doctoraltypeph.d.en_US
dc.description.popularabstractDiabetes mellitus is a chronic disease affecting an increasing number of individuals worldwide. Diabetes type 2 is most common, and the growing burden of the disease is driven by unhealthy diets, sedentary lifestyles, inactivity, obesity, urbanisation, and increased detection of the disease. Over time, diabetes can damage the heart, eyes, kidneys, blood vessels, and nerves. Most individuals are treated in primary care. Individuals with advanced diseases should be referred to specialist care. In this thesis, we used data from the ROSA 4 study. We aimed to study the prevalence of diabetes and complications, attained treatment targets, and level of health care. Our results showed that the prevalence of diabetes was slightly lower than anticipated. Individuals in specialist care had more complications. Heart and kidney disease was less common in those with higher education. Our findings indicate adherence to priority guidelines. Particular attention should be given to those with lower education.en_US
dc.description.sponsorshipHelse Norden_US
dc.identifier.urihttps://hdl.handle.net/10037/26725
dc.language.isoengen_US
dc.publisherUiT The Arctic University of Norwayen_US
dc.publisherUiT Norges arktiske universiteten_US
dc.relation.haspart<p>Paper 1: Slåtsve, K.B., Claudi, T., Lappegård, K.T., Jenum, A.K., Larsen, M., Cooper, J.G., Sandberg, S. & Berg, T.J. (2022). The total prevalence of diagnosed diabetes and the quality of diabetes care for the adult population in Salten, Norway. <i>Scandinavian Journal of Public Health, 50</i>(2), 161-171. Also available in Munin at <a href=https://hdl.handle.net/10037/19852>https://hdl.handle.net/10037/19852</a>. <p>Paper 2: Slåtsve, K.B., Claudi, T., Lappegård, K.T., Jenum, A.K., Larsen, M., Nøkleby, K., Cooper, J.G., Sandberg, S. & Berg, T.J. (2021). Factors associated with treatment in primary versus specialist care: A population-based study of people with type 2 and type 1 diabetes. <i>Diabetic Medicine, 38</i>(7), e14580. Also available in Munin at <a href=https://hdl.handle.net/10037/21531>https://hdl.handle.net/10037/21531</a>. <p>Paper 3: Slåtsve, K.B., Claudi, T., Lappegård, K.T., Jenum, A.K., Larsen, M., Nøkleby, K., … Berg, T.J. Level of education is associated with coronary heart disease and chronic kidney failure in individuals with type 2 diabetes: A population-based study. (Submitted manuscript).en_US
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2022 The Author(s)
dc.subject.courseIDDOKTOR-003
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800en_US
dc.subjectVDP::Medical disciplines: 700::Health sciences: 800en_US
dc.titlePrevalence, vascular complications, and level of health care treatment in individuals with type 2 and type 1 diabetes mellitusen_US
dc.typeDoctoral thesisen_US
dc.typeDoktorgradsavhandlingen_US


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