shh.sePublications
Change search
Refine search result
1 - 50 of 50
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1. Amsberg, Susanne
    et al.
    Wijk, Ingrid
    Livheim, Fredrik
    Toft, Eva
    Johansson, Unn-Britt
    Sophiahemmet University.
    Anderbro, Therese
    Acceptance and commitment therapy (ACT) for adult type 1 diabetes management: study protocol for a randomised controlled trial2018In: BMJ Open, E-ISSN 2044-6055, Vol. 8, no 11, article id e022234Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Integrating diabetes self-management into daily life involves a range of complex challenges for affected individuals. Environmental, social, behavioural and emotional psychological factors influence the lives of those with diabetes. The aim of this study is to evaluate the impact of a stress management group intervention based on acceptance and commitment therapy (ACT) among adults living with poorly controlled type 1 diabetes.

    METHODS AND ANALYSIS: This study will use a randomised controlled trial design evaluating treatment as usual (TAU) and ACT versus TAU. The stress management group intervention will be based on ACT and comprises a programme divided into seven 2-hour sessions conducted over 14 weeks. A total of 70 patients who meet inclusion criteria will be recruited over a 2-year period with follow-up after 1, 2 and 5 years.The primary outcome measure will be HbA1c. The secondary outcome measures will be the Depression Anxiety Stress Scales, the Swedish version of the Hypoglycemia Fear Survey, the Swedish version of the Problem Areas in Diabetes Scale, The Summary of Self-Care Activities, Acceptance Action Diabetes Questionnaire, Swedish Acceptance and Action Questionnaire and the Manchester Short Assessment of Quality of Life. The questionnaires will be administered via the internet at baseline, after sessions 4 (study week 7) and 7 (study week 14), and 6, 12 and 24 months later, then finally after 5 years. HbA1c will be measured at the same time points.Assessment of intervention effect will be performed through the analysis of covariance. An intention-to-treat approach will be used. Mixed-model repeated measures will be applied to explore effect of intervention across all time points.

    ETHICS AND DISSEMINATION: The study has received ethical approval (Dnr: 2016/14-31/1). The study findings will be disseminated through peer-reviewed publications, conferences and reports to key stakeholders.

    TRIAL REGISTRATION NUMBER: NCT02914496; Pre-results.

    Download full text (pdf)
    fulltext
  • 2. Anderbro, Therese
    et al.
    Amsberg, Susanne
    Moberg, Erik
    Gonder-Frederick, Linda
    Adamson, Ulf
    Lins, Per-Eric
    Johansson, Unn-Britt
    Sophiahemmet University.
    A longitudinal study of fear of hypoglycaemia in adults with type 1 diabetes2018In: Endocrinology, Diabetes & Metabolism, ISSN 2057-3316, Vol. 1, no 2Article in journal (Refereed)
    Abstract [en]

    Aims: To  investigate  fear  of  hypoglycaemia  (FoH)  longitudinally  in  a  cross-  sectional  study  of  adult  patients  with  type  1  diabetes.  Specifically,  we  investigated  two  sub-groups of patients who over 4 years either showed a substantial increase or decrease in level of FoH to identify factors associated with changes in FoH.

    Methods: The Swedish version of the Hypoglycaemia Fear Survey (HFS) along with a questionnaire  to  assess  hypoglycaemia  history  was  sent  by  mail  to  764  patients  in  2010. The responders in 2010 (n =   469) received another set of the same two ques-tionnaires in 2014. HbA1c, insulin regimen, weight and creatinine from 2010 and 2014 were obtained from medical records. Those with an absolute difference in HFS scores ≥  75th percentile were included in   the    subgroup analyses. Statistical analyses included one- sample t tests, chi- square and McNemar’s test.

    Results: The absolute difference in the HFS total score (n =   347) between 2010 and 2014 was m =   ±7.6, SD ±   6. In the increased FoH group, more patients reported a high level of moderate hypoglycaemic episodes as well as impaired awareness of hypogly-caemia in 2014 compared with the decreased FoH group. There were more subjects in the  increased  FoH  group  with  insulin  pumps  in  2014  and  in  2010.  In  the  decreased  FoH group, more patients had a high frequency of daily self- monitoring of blood glu-cose (SMBG) in 2010 and in 2014.

    Conclusions: Fear of hypoglycaemia is stable across time for most patients. Changes in fear level are associated with changes in hypoglycaemia frequency. Thus, asking pa-tients about changes in hypoglycaemia experiences is of great importance.

    Download full text (pdf)
    fulltext
  • 3. Anderbro, Therese
    et al.
    Moberg, E
    Gonder-Frederick, L
    Lins, P E
    Adamson, U
    Johansson, Unn-Britt
    Sophiahemmet University.
    A longitudinal study of fear of hypoglycemia in type 1 diabetes2015Conference paper (Other academic)
  • 4. Anderbro, Therese
    et al.
    Moberg, Erik
    Adamson, Ulf
    Lins, Per-Eric
    Johansson, Unn-Britt
    Sophiahemmet University.
    Beliefs and experiences of fear of hypoglycemiaand use of uncooked cornstarch before bedtime in persons with type 1-diabetes2018In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 8, p. 795-810Article in journal (Refereed)
    Abstract [en]

    Introduction: Among persons living with type 1-diabetes hypoglycemia and fear of hypoglycemia remain limiting barriers for achieving optimal glucose control and a good quality of life. Fear of hypoglycemia has been found stable over time if not treated. Uncooked cornstarch has been found to reduce the risk of hypoglycemia but has not been studied in relation to fear of hypogly-cemia. The aims of this study were to through clinical data, self-reported measures and clinical interviews explore subjects’ experience of using un-cooked cornstarch before bedtime and their beliefs and experiences of fear of hypoglycemia.

    Methods: Mixed methods with both quantitative and qualita-tive data were used. Self-reported measures of hypoglycemia and fear of hy-poglycemia were compared to subjects’ responses during a clinical interview. The interviews were analyzed with a functional behavior analytical approach.

    Results: A total of five subjects took part in the study. One subject perceived the uncooked cornstarch helpful in reducing hypoglycemia. Several subjects could recall frightening hypoglycemic episodes triggering their fear. Three out of the five subjects reported avoidance behaviors such as excessive self-monitoring of blood glucose or overeating related to fear of hypoglyce-mia. Conclusions: The uncooked cornstarch was found appetizing but was not perceived as having an effect on BG or hypoglycemia frequency. The clinical interviews confirmed previous research regarding experience of hy-poglycemia and fear of hypoglycemia.

    Download full text (pdf)
    fulltext
  • 5. Eeg-Olofsson, Katarina
    et al.
    Johansson, Unn-Britt
    Sophiahemmet University.
    Linder, Ebba
    Leksell, Janeth
    Patients' and health care professionals' perceptions of the potential of using the digital Diabetes Questionnaire to prepare for diabetes care meetings: Qualitative focus group interview study2020In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 22, no 8, article id e17504Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In effective diabetes management, it is important that providers and health care systems prioritize the delivery of patient-centered care and that they are respectful of and responsive to individual patient preferences and barriers.

    OBJECTIVE: The objective of the study was to conduct focus group interviews to capture patients' and health care professionals' perceptions and attitudes regarding digital technology and to explore how the digital Diabetes Questionnaire can be used to support patient participation in diabetes care, as a basis for an implementation study.

    METHODS: A qualitative study was conducted with six focus group discussions with diabetes specialist nurses and medical doctors (n=29) and four focus group discussions with individuals with diabetes (n=23). A semistructured focus group interview guide was developed, including probing questions. The data were transcribed verbatim, and qualitative content analysis was performed using an inductive approach.

    RESULTS: Two main categories were revealed by the qualitative analysis: perceptions of digital technology and the digital questionnaire in diabetes management and care and perceptions of participation in diabetes care. An overarching theme that emerged from the focus group interviews was patients' and professionals' involvement in diabetes care using digital tools.

    CONCLUSIONS: The analysis identified important factors to consider when introducing the digital Diabetes Questionnaire in clinical use. Both professionals and patients need support and training in the practical implementation of the digital questionnaire, as well as the opportunity to provide feedback on the questionnaire answers.

    Download full text (pdf)
    fulltext
  • 6. Eeg-Olofsson, Katarina
    et al.
    Svedbo Engström, Maria
    Borg, Sixten
    Palaszewski, Bo
    Lexell, Janeth
    Johansson, Unn-Britt
    Sophiahemmet University.
    Gudbjörnsdottir, Soffia
    Glycaemic control and patient-reported outcome measures (PROMs) in type 1 diabetes2016Conference paper (Other academic)
  • 7. Forde, Rita
    et al.
    Arente, Liga
    Ausili, Davide
    De Backer, Kristin
    Due-Christensen, Mette
    Epps, Amanda
    Fitzpatrick, Anne
    Grixti, Moira
    Groen, Sijda
    Halkoaho, Arja
    Huber, Claudia
    Iversen, Marjolein M
    Johansson, Unn-Britt
    Sophiahemmet University.
    Leippert, Claudia
    Ozcan, Seyda
    Parker, Julie
    Paiva, Ana Christina
    Sanpetreanu, Adina
    Savet, Marie-Alice
    Rosana, Svetic-Cisic
    Szewczyk, Alicja
    Valverde, Maite
    Vlachou, Eugenia
    Forbes, Angus
    The Impact of the COVID-19 pandemic on people with diabetes and diabetes services: A pan-European survey of diabetes specialist nurses undertaken by the Foundation of European Nurses in Diabetes survey consortium2021In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 38, no 5, article id e14498Article in journal (Refereed)
    Abstract [en]

    AIM: To describe diabetes nurses' perspectives on the impact of the COVID-19 pandemic on people with diabetes and diabetes services across Europe.

    METHODS: An online survey developed using a rapid Delphi method. The survey was translated into 17 different languages and disseminated electronically in 27 countries via national diabetes nurse networks.

    RESULTS: Survey responses from 1829 diabetes nurses were included in the analysis. The responses indicated that 28% (n=504) and 48% (n=873) of diabetes nurses felt the COVID-19 pandemic had impacted 'a lot' on the physical and psychological risks of people with diabetes, respectively. The following clinical problems were identified as having increased 'a lot': anxiety 82% (n=1486); diabetes distress 65% (n=1189); depression 49% (n= 893); acute hyperglycaemia 39% (n=710); and foot complications 17% (n=323). Forty-seven percent (n=771) of respondents identified that the level of care provided to people with diabetes had declined either extremely or quite severely. Self-management support, diabetes education and psychological support were rated by diabetes nurse respondents as having declined extremely or quite severely during the COVID-19 pandemic by 31% (n=499), 63% (n=1,027) and 34% (n=551), respectively.

    CONCLUSION: The findings show that diabetes nurses across Europe have seen significant increases in both physical and psychological problems in their patient populations during COVID-19. The data also show that clinical diabetes services have been significantly disrupted. As the COVID-19 situation continues we need to adapt care systems with some urgency to minimise the impact of the pandemic on the diabetes population.

  • 8. Freyschuss, Bo
    et al.
    Johansson, Unn-Britt
    Sophiahemmet University.
    Leksell, Janeth
    Steen Carlsson, Katarina
    Thorsén, Håkan
    Werkö, Sophie
    Wikblad, Karin
    Hammarlund, Cecilia
    Johansson, Ida
    Patientutbildning vid diabetes: en systematisk litteraturöversikt2009Report (Other academic)
  • 9. Funkquist, Anders
    et al.
    Wandt, Birger
    Blennow, Kaj
    Zetterberg, Henrik
    Svensson, Johan
    Bjellerup, Per
    Freund-Levi, Yvonne
    Sjöberg, Stefan
    Sophiahemmet University.
    Higher CSF/serum free-T4 ratio is associated with improvement of quality of life during treatment with L-thyroxine2023In: Journal of neuroendocrinology, ISSN 0953-8194, E-ISSN 1365-2826, Vol. 35, no 5, p. e13272-, article id e13272Article in journal (Refereed)
    Abstract [en]

    Up to 20% of individuals with primary hypothyroidism treated with L-thyroxine still suffer from severe symptoms. These are supposedly brain derived and involve both cognitive and emotional domains. Previously, no consistent relationship has been found between thyroid hormones (TH) or TSH levels in blood and quality of life (QoL). Recently, we reported an association between cerebrospinal fluid (CSF)/serum free-thyroxine (f-T4) ratio and QoL, in juvenile hypothyroid patients. Here, we investigated if CSF/serum f-T4 ratio and QoL estimates correlate also during L-thyroxine treatment. Moreover, the CSF biomarker neurogranin (Ng) was used as a biomarker for synaptic function and integrity in clinical research. Ng is partially controlled by TH and therefore we investigated the relationship between QoL parameters and Ng levels. Patients diagnosed with primary hypothyroidism were investigated using vital parameters, serum and CSF analyses of TH, TSH, Ng and QoL questionnaires. Similar procedures were performed after 6 months of treatment. The most marked associations with QoL were found for CSF/serum f-T4 ratio, which was strongly related to several QoL parameters such as the mental subscore of SF-36 (r = 0.83, p < .0005). Ng, which did not differ from that in our healthy controls, was lower in some patients during treatment and higher in others. However, the change in Ng during treatment was significantly correlated with QoL parameters including the mental subscore of SF-36 (r = -0.86, p < .0001). In addition, the CSF/serum f-T4 ratio correlated with the change in Ng (r = -0.75, p = .001). Our results suggest that the ratio between CSF and serum f-T4 is an important biomarker for QoL during treatment of patients with primary hypothyroidism, so far in research, but in the future maybe also in clinical settings. Moreover, this ratio also correlates with the changes in Ng levels during L-thyroxine treatment, further supporting the impact of the TH balance between serum and CSF on QoL.

    Download full text (pdf)
    fulltext
  • 10. Hanås, R
    et al.
    Lindholm Olinder, A
    Olsson, P.O
    Johansson, Unn-Britt
    Sophiahemmet University.
    Jacobson, S
    Heintz, E
    Werkö, Sophie
    Persson, M
    CSII and SAP valuable tools in the treatment of diabetes: a Swedish health technology assessment2014In: Diabetes Technology & Therapeutics, ISSN 1520-9156, E-ISSN 1557-8593, Vol. 16, no Suppl 1, p. A-56-Article in journal (Refereed)
  • 11.
    Johansson, Unn-Britt
    Sophiahemmet University.
    Sophia Step Study2017Conference paper (Other academic)
  • 12.
    Johansson, Unn-Britt
    et al.
    Sophiahemmet University.
    Cederblad, Lars
    Egenmonitorering vid typ 2 diabetes och vårdpersonalens erfarenheter av att använda digitala analysverktyg i vårdmötet2022Conference paper (Other academic)
  • 13.
    Johansson, Unn-Britt
    et al.
    Sophiahemmet University.
    Hanås, Ragnar
    Olsson, Per-Olof
    Lindholm Olinder, Anna
    Persson, Martina
    Werkö, Sophie
    Jacobson, Stella
    Heintz, Emelie
    Akcan, Derya
    Attergren Granath, Anna
    Davidson, Thomas
    Insulinpumpar vid diabetes2013Report (Other academic)
    Abstract [sv]

    God kontroll av blodglukosnivån är viktig för att undvika följdsjukdomar av diabetes. Vid typ 1-diabetes och en del fall av typ 2-diabetes krävs så kallad intensiv insulinbehandling med flera injektioner per dag. Den vanligaste komplikationen vid denna behandling är lågt blodglukos (hypoglykemi) vilket kan få allvarliga följder [1,2]. Ett alternativ till intensiv insulinbehandling med injektioner är kontinuerlig insulintillförsel med pump, så kallad kontinuerlig subkutan insulininfusion (CSII).

  • 14.
    Johansson, Unn-Britt
    et al.
    Sophiahemmet University.
    Hanås, Ragnar
    Olsson, Per-Olof
    Lindholm Olinder, Anna
    Persson, Martina
    Werkö, Sophie
    Jacobson, Stella
    Heintz, Emelie
    Akcan, Derya
    Attergren Granath, Anna
    Davidson, Thomas
    Kontinuerlig subkutan glukosmätning vid diabetes2013Report (Other academic)
    Abstract [sv]

    God kontroll av blodglukosnivån är viktig för att undvika följdsjukdomar av diabetes. Blodglukos kan mätas av patienten själv med teststickor (self monitoring of blood glucose, SMBG) eller via en subkutan sensor (kontinuerlig subkutan glukosmätning, CGM). Vid typ 1-diabetes behövs rutinmässigt upprepade blodglukosmätningar varje dygn för att uppnå god glukoskontroll.

    SBU har utvärderat nytta och risk av behandling med kontinuerlig glukosmätning utan eller med insulinpump (SAP) vid diabetes hos barn, ungdomar och vuxna. I utvärderingen ingår också en hälsoekonomisk och etisk analys, samt en stor praxisundersökning som omfattade samtliga diabeteskliniker i Sverige

  • 15.
    Johansson, Unn-Britt
    et al.
    Sophiahemmet University.
    Wredling, Regina
    Sophiahemmet University.
    Adamson, Ulf
    Lins, Per-Eric
    A morning dose of insulin glargine prevents nocturnal ketosis after postprandial interruption of continuous subcutaneous insulin infusion with insulin lispro2007In: Diabetes & Metabolism, ISSN 1262-3636, E-ISSN 1878-1780, Vol. 33, no 6, p. 469-71Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this crossover trial was to evaluate the potential of partial substitution of basal insulin with glargine, administered once daily in the morning, to protect against nocturnal ketosis after postprandial interruption of continuous subcutaneous insulin infusion (CSII). METHODS: Seven patients with type 1 diabetes received 4 weeks of treatment with insulin lispro, administered by CSII, and 4 weeks of treatment with CSII and a partial basal replacement dose of insulin glargine administered in the morning. On day 28 of each treatment phase, patients were admitted to the research unit where dinner was served and their usual dinner insulin bolus dose given, after which CSII was discontinued at 7 pm. Plasma (p) beta-hydroxybutyrate and p glucose were measured every hour for 12 h thereafter. RESULTS: Plasma beta-hydroxybutyrate at 7 pm was 0.16+/-0.05 and 0.13+/-0.07 mmol/l with and without glargine, respectively, and increased to 0.17+/-0.10 and 0.60+/-0.3 mmol/l within 6 h (P=0.02). Plasma glucose increased without glargine, from 8.6+/-2.9 to 21.1+/-3.0 mmol/l (P=0.003), but did not rise significantly following glargine (13.6+/-4.7 vs. 12.6+/-5.6 mmol/l; P=0.65). CONCLUSIONS: Partial replacement with a morning dose of insulin glargine protects against the development of ketosis for as much as 12 h after postprandial interruption of CSII. This treatment strategy could, therefore, be useful for patients who are prone to ketosis but, for other reasons, are deemed suitable for CSII.

  • 16.
    Kullenberg, Helena
    et al.
    Sophiahemmet University.
    Nyström, Thomas
    Kumlin, Maria
    Sophiahemmet University.
    Svedberg, Marie
    Sophiahemmet University.
    Correlation between insulin-degrading enzyme versus total tau and selected cytokines in patients with Alzheimer´s disease compared to non-demented controls.2023In: Neuroendocrinology Letters, ISSN 2354-4716, Vol. 44, no 4, p. 199-205Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: It has been increasingly recognized that the pathological progress of Alzheimer´s disease (AD) is connected to metabolic function and inflammation. Insulin-degrading enzyme (IDE) is essential for glucose metabolism and the degradation of amyloid-β. We aimed to explore the associations between IDE, total tau, and cytokines levels in plasma from subjects with AD and non-demented controls.

    METHODS AND MATERIAL: Plasma samples (18 patients diagnosed with AD and 6 non-demented controls) from the Netherlands Brain Bank were used to analyze IDE levels and total tau with an enzyme-linked immunosorbent assay. Cytokines were analyzed with Luminex custom plex assays for interleukin (IL)-6, IL-8, IL-10, and tumor necrosis factor-alpha (TNF-α). Results were analyzed using the Mann-Whitney U and Spearman´s rank correlation tests.

    RESULTS: Total tau in plasma was significantly increased in AD subjects compared to non-demented control subjects (p = 0.044). Total tau was positively correlated with IDE levels in plasma in all subjects (r = 0.494, p = 0.017). Significant correlations could be demonstrated between plasma levels of IDE and IL-6 (r = 0.546, p = 0.019), IL-8 (r = 0.664, p = 0.003), IL-10 (r = 0.833, p < 0.001), and TNF-α (r = 0.633, p = 0.005) in subjects with AD, but not in non-demented controls.

    CONCLUSION: Results from this study suggest that plasma IDE levels may be associated with inflammation and neurodegeneration and could potentially be a target for future diagnostic and treatment strategies.

    Download full text (pdf)
    fulltext
  • 17.
    Kullenberg, Helena
    et al.
    Sophiahemmet University.
    Rossen, Jenny
    Sophiahemmet University.
    Johansson, Unn-Britt
    Sophiahemmet University.
    Hagströmer, Maria
    Sophiahemmet University.
    Nyström, Thomas
    Kumlin, Maria
    Sophiahemmet University.
    Svedberg, Marie
    Sophiahemmet University.
    Correlations between insulin-degrading enzyme and metabolic markers in patients diagnosed with type 2 diabetes, Alzheimer's disease, and healthy controls: A comparative studyManuscript (preprint) (Other academic)
  • 18.
    Kullenberg, Helena
    et al.
    Sophiahemmet University.
    Rossen, Jenny
    Sophiahemmet University.
    Johansson, Unn-Britt
    Sophiahemmet University.
    Hagströmer, Maria
    Sophiahemmet University.
    Nyström, Thomas
    Kumlin, Maria
    Sophiahemmet University.
    Svedberg, Marie
    Sophiahemmet University.
    Correlations between insulin-degrading enzyme and metabolic markers in patients diagnosed with type 2 diabetes, Alzheimer's disease, and healthy controls: A comparative study2023In: Endocrine, ISSN 1355-008X, E-ISSN 1559-0100Article in journal (Refereed)
    Abstract [en]

    PURPOSE: This study aimed to explore correlations between insulin-degrading enzyme (IDE) and markers of metabolic function in a group of patients diagnosed with type 2 diabetes mellitus (T2DM) or Alzheimer's disease (AD) and metabolically healthy volunteers.

    METHOD: We included 120 individuals (47 with T2DM, 9 with AD, and 64 healthy controls). Serum levels of IDE were measured with commercial kits for ELISA. Differences in IDE levels between groups were analyzed with non-parametric ANCOVA, and correlations were analyzed with Spearman's rank correlations. We also investigated the influence of age, sex, and the use of insulin on the correlation using a non-parametric version of partial correlation.

    RESULTS: Patients diagnosed with T2DM had higher IDE levels than patients diagnosed with AD and healthy controls after adjustment for age and sex. IDE was increasingly associated with body mass index (BMI), fasting blood glucose, C-peptide, hemoglobin A1c (HbA1c), insulin resistance, and triglycerides. In stratified analyses, we found a decreasing partial correlation between IDE and HbA1c in patients diagnosed with AD and a decreasing partial correlation between IDE and C-peptide in healthy controls. In patients diagnosed with T2DM, we found no partial correlations.

    CONCLUSION: These results indicate that IDE is essential in metabolic function and might reflect metabolic status, although it is not yet a biomarker that can be utilized in clinical practice. Further research on IDE in human blood may provide crucial insights into the full function of the enzyme.

    Download full text (pdf)
    fulltext
  • 19.
    Kullenberg, Helena
    et al.
    Sophiahemmet University.
    Rossen, Jenny
    Sophiahemmet University.
    Johansson, Unn-Britt
    Sophiahemmet University.
    Hagströmer, Maria
    Sophiahemmet University.
    Nyström, Thomas
    Kumlin, Maria
    Sophiahemmet University.
    Svedberg, Marie
    Sophiahemmet University.
    Increased levels of insulin-degrading enzyme in patients with type 2 diabetes mellitus2022In: Endocrine, ISSN 1355-008X, E-ISSN 1559-0100, Vol. 77, no 3, p. 561-565Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Decreasing levels of serum insulin-degrading enzyme (IDE) have been associated with an increased risk for Alzheimer´s disease (AD) in patients with type 2 diabetes mellitus (T2DM). Research on serum IDE levels in patients with T2DM is sparse and the aim of this study was to explore serum levels of IDE in patients with T2DM.

    METHOD: Blood serum samples were obtained from a biobank. Samples from subjects with T2DM and without metabolic disease were divided into subgroups; lifestyle treatment (n = 10), oral antidiabetic treatment (n = 17), insulin treatment (n = 20) and metabolically healthy controls (n = 18). Serum levels of IDE were analysed using specific ELISA assays.

    RESULTS: Serum levels of IDE were elevated in subjects with T2DM compared to metabolically healthy individuals (p = 0.033). No significant differences were detected between treatment subgroups.

    CONCLUSION: The present study indicates that patients with T2DM have increased serum IDE levels, compared to metabolically healthy individuals. However, for IDE to be clinically useful as a biomarker, its full function and possible use needs to be further elucidated in larger studies showing reproducible outcomes.

  • 20.
    Kullenberg, Helena
    et al.
    Sophiahemmet University.
    Wibom, Moa
    Kumlin, Maria
    Sophiahemmet University.
    Nyström, Thomas
    Svedberg, Marie
    Sophiahemmet University.
    Associations between the use of metformin and behavioral and psychological symptoms in patients with Alzheimer's disease, and type 2 diabetes mellitus: A register-based study2023In: Current Alzheimer Research, ISSN 1567-2050, E-ISSN 1875-5828, Vol. 20, no 2, p. 109-119Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Metformin, the first-line anti-diabetic drug treatment in patients with type 2 diabetes mellitus (T2DM), is suggested to be anti-inflammatory, antioxidative, and improve cognitive function, making it a promising contribution to treating Alzheimer´s disease (AD). However, the effect of metformin on behavioral and psychological symptoms of dementia (BPSD) in patients with AD has not been explored.

    OBJECTIVE: To investigate the associations between metformin and BPSD in patients with AD and T2DM and explore possible interaction with other antidiabetic drugs.

    METHODS: This cross-sectional study was based on data from the Swedish BPSD register. A total of 3745 patients with AD and antidiabetic drug treatment were included. Associations and interactions between antidiabetic drugs and BPSD were investigated by binary logistic regression.

    RESULTS: The use of metformin was associated with lower odds for symptoms of depression (OR 0.77, CI (95%) 0.61-0.96, p = 0.022) and anxiety (OR 0.74, CI (95%) 0.58-0.94, p = 0.015) after adjustment for age, gender, specific diagnosis, and drugs. We could not demonstrate this association with another antidiabetic drug. Interaction effects were limited to an increasing association in eating and appetite disorders using metformin and other antidiabetic drugs (i.e., drugs other than insulin, sulfonylurea, or dipeptidyl peptidase-4 inhibitors).

    CONCLUSION: The result of this study suggests that metformin could be beneficial for patients diagnosed with AD, other than for blood glucose control. Although, more knowledge is needed before assigning metformin a role in treating BPSD.

  • 21.
    Kullenberg, Helena
    et al.
    Sophiahemmet University.
    Wibom, Moa
    Nyström, Thomas
    Kumlin, Maria
    Sophiahemmet University.
    Svedberg, Marie
    Sophiahemmet University.
    Behavioral and psychological symptoms in patients with cognitive disease and diabetes: A register based study2022Conference paper (Other academic)
  • 22.
    Larsson, Kristina
    et al.
    Sophiahemmet University.
    von Rosen, Philip
    Rossen, Jenny
    Sophiahemmet University.
    Johansson, Unn-Britt
    Sophiahemmet University.
    Hagströmer, Maria
    Sophiahemmet University.
    Changes in physical activity behaviour over a period of two years in people with type 2 diabetes or prediabetes2021Conference paper (Other academic)
  • 23.
    Larsson, Kristina
    et al.
    Sophiahemmet University.
    von Rosen, Philip
    Rossen, Jenny
    Sophiahemmet University.
    Johansson, Unn-Britt
    Sophiahemmet University.
    Hagströmer, Maria
    Sophiahemmet University.
    The effect of a pedometer-based intervention across two years, in people with type 2 diabetes and prediabetes: A compositional data analysis2022Conference paper (Other academic)
  • 24. Lindholm Olinder, A
    et al.
    Hanås, R
    Heintz, E
    Jacobson, S
    Johansson, Unn-Britt
    Sophiahemmet University.
    Olsson, P.O
    Persson, M
    Werkö, Sophie
    CGM and SAP are valuable tools in the treatment of diabetes: a Swedish health technology assessment2014In: Diabetes Technology & Therapeutics, ISSN 1520-9156, E-ISSN 1557-8593, Vol. 16, no Suppl 1, p. A-74-Article in journal (Refereed)
  • 25. Mc Laughlin, Sue
    et al.
    Chaney, David
    Belton, Anne
    Garst, Jilde
    International standards for education of diabetes health professionals2015Book (Other academic)
  • 26.
    Rossen, Jenny
    Sophiahemmet University.
    "But now it is a habit": Participants' experiences of Sophia Step Study2017Conference paper (Other academic)
  • 27.
    Rossen, Jenny
    et al.
    Sophiahemmet University.
    Buman, Matthew P
    Johansson, Unn-Britt
    Sophiahemmet University.
    Yngve, Agneta
    Sophiahemmet University.
    Ainsworth, Barbara
    Brismar, Kerstin
    Hagströmer, Maria
    Reallocating bouted sedentary time to non-bouted sedentary time, light activity and moderate-vigorous physical activity in adults with prediabetes and type 2 diabetes2017In: PLOS ONE, E-ISSN 1932-6203, Vol. 12, no 7, article id e0181053Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to investigate the potential associations of reallocating 30 minutes sedentary time in long bouts (>60 min) to sedentary time in non-bouts, light intensity physical activity (LPA) and moderate- to vigorous physical activity (MVPA) with cardiometabolic risk factors in a population diagnosed with prediabetes or type 2 diabetes.

    METHODS: Participants diagnosed with prediabetes and type 2 diabetes (n = 124, 50% men, mean [SD] age = 63.8 [7.5] years) were recruited to the physical activity intervention Sophia Step Study. For this study baseline data was used with a cross-sectional design. Time spent in sedentary behaviors in bouts (>60 min) and non-bouts (accrued in <60 min bouts) and physical activity was measured using the ActiGraph GT1M. Associations of reallocating bouted sedentary time to non-bouted sedentary time, LPA and MVPA with cardiometabolic risk factors were examined using an isotemporal substitution framework with linear regression models.

    RESULTS: Reallocating 30 minutes sedentary time in bouts to MVPA was associated with lower waist circumference (b = -4.30 95% CI:-7.23, -1.38 cm), lower BMI (b = -1.46 95% CI:-2.60, -0.33 kg/m2) and higher HDL cholesterol levels (b = 0.11 95% CI: 0.02, 0.21 kg/m2. Similar associations were seen for reallocation of sedentary time in non-bouts to MVPA. Reallocating sedentary time in bouts to LPA was associated only with lower waist circumference.

    CONCLUSION: Reallocation of sedentary time in bouts as well as non-bouts to MVPA, but not to LPA, was beneficially associated with waist circumference, BMI and HDL cholesterol in individuals with prediabetes and type 2 diabetes. The results of this study confirm the importance of reallocation sedentary time to MVPA.

    Download full text (pdf)
    fulltext
  • 28.
    Rossen, Jenny
    et al.
    Sophiahemmet University.
    Hagströmer, Maria
    Sophiahemmet University.
    Johansson, Unn-Britt
    Sophiahemmet University.
    Study center differences in demographics and intervention impact after 6 months of Sophia Step Study2019Conference paper (Other academic)
  • 29.
    Rossen, Jenny
    et al.
    Sophiahemmet University.
    Hagströmer, Maria
    Sophiahemmet University.
    Yngve, Agneta
    Brismar, Kerstin
    Ainsworth, Barbara
    Johansson, Unn-Britt
    Sophiahemmet University.
    Process evaluation of the Sophia Step Study: A primary care based three-armed randomized controlled trial using self-monitoring of steps with and without counseling in prediabetes and type 2 diabetes2021In: BMC Public Health, E-ISSN 1471-2458, Vol. 21, no 1, article id 1191Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Describing implementation features of an intervention is required to compare interventions and to inform policy and best practice. The aim of this study was to conduct a process evaluation of the first 12 months of the Sophia Step Study: a primary care based RCT evaluating a multicomponent (self-monitoring of daily steps plus counseling) and a single component (self-monitoring of steps only) physical activity intervention to standard care on cardiometabolic health.

    METHODS: The evaluation was guided by the Medical Research Council Guidance for complex interventions. To describe the implementation communication with the health professionals implementing the interventions, attendance records and tracking of days with self-monitored pedometer-determined steps were used. Change in physical activity behaviour was measured at baseline, 6 and 12 months as daily steps by accelerometry.

    RESULTS: During April 2013 to January 2018 188 participants were randomized and intervened directly after inclusion. Response rate was 49% and drop out was 10%. A majority, 78%, had type 2 diabetes and 22% were diagnosed with prediabetes. Mean [Standard deviation (SD)] body mass index was 30.4 (4.4) kg/m2 and steps per day was 6566 (3086). The interventions were delivered as intended with minor deviation from the protocol and dose received was satisfying for both the multicomponent and single component group. The mean [95% Confidence Interval (CI)] change in daily steps from baseline to 6 months was 941(227, 1655) steps/day for the multicomponent intervention group, 990 (145, 1836) step/day for the single component group and - 506 (- 1118, 107) for the control group. The mean (95% CI) change in daily steps from baseline to 12 months was 31(- 507, 570) steps/day for the multicomponent intervention group, 144 (- 566, 853) step/day for the single component group and - 890 (- 1485, - 294) for the control group. There was a large individual variation in daily steps at baseline as well as in step change in all three groups.

    CONCLUSIONS: Applying self-monitoring of steps is a feasible method to implement as support for physical activity in the primary care setting both with and without counseling support.

    TRIAL REGISTRATION: ClinicalTrials.gov , NCT02374788 . Registered 2 March 2015.

    Download full text (pdf)
    fulltext
  • 30.
    Rossen, Jenny
    et al.
    Sophiahemmet University.
    Hagströmer, Maria
    Yngve, Agneta
    Brismar, Kerstin
    Ainsworth, Barbara
    Johansson, Unn-Britt
    Sophiahemmet University.
    Process evaluation of the Sophia Step Study: A three-armed randomized controlled trial using self-monitoring of steps with and without counselling in pre- and type 2 diabetesManuscript (preprint) (Other academic)
  • 31.
    Rossen, Jenny
    et al.
    Sophiahemmet University.
    Hagströmer, Maria
    Yngve, Agneta
    Brismar, Kerstin
    Johansson, Unn-Britt
    Sophiahemmet University.
    Self-management of physical activity by the use of step registration in type 2 diabetes: Six months results of the RCT Sophia Step Study2018Conference paper (Other academic)
  • 32.
    Rossen, Jenny
    et al.
    Sophiahemmet University.
    Johansson, Unn-Britt
    Sophiahemmet University.
    Hagströmer, Maria
    Yngve, Agneta
    Sophiahemmet University.
    Sophia Step Study: en metod för att öka patienternas fysiska aktivitetsnivå2016In: BestPractice Diabets/Hjärt-kärlsjukdomar, Vol. 6, no 19, p. 16-18Article in journal (Other (popular science, discussion, etc.))
  • 33.
    Rossen, Jenny
    et al.
    Sophiahemmet University.
    Johansson, Unn-Britt
    Sophiahemmet University.
    Lööf, Helena
    Sophiahemmet University.
    Hagströmer, Maria
    Yngve, Agneta
    Exploration of study participants experiences following Sophia Step Study: A two-year physical activity intervention2016Conference paper (Other academic)
  • 34.
    Rossen, Jenny
    et al.
    Sophiahemmet University.
    Larsson, Kristina
    Sophiahemmet University.
    Hagströmer, Maria
    Sophiahemmet University.
    Yngve, Agneta
    Brismar, Kerstin
    Ainsworth, Barbara
    Åberg, Linda
    Johansson, Unn-Britt
    Sophiahemmet University.
    Effects of a three-armed randomised controlled trial using self-monitoring of daily steps with and without counselling in prediabetes and type 2 diabetes: The Sophia Step Study2021In: International Journal of Behavioral Nutrition and Physical Activity, E-ISSN 1479-5868, Vol. 18, no 1, article id 121Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: This aimed to evaluate the effects of self-monitoring of daily steps with or without counselling support on HbA1c, other cardiometabolic risk factors and objectively measured physical activity (PA) during a 2-year intervention in a population with prediabetes or type 2 diabetes.

    METHODS: The Sophia Step Study was a three-armed parallel randomised controlled trial. Participants with prediabetes or type 2 diabetes were recruited in a primary care setting. Allocation (1:1:1) was made to a multi-component intervention (self-monitoring of steps with counselling support), a single-component intervention (self-monitoring of steps without counselling support) or standard care. Data were collected for primary outcome HbA1c at baseline and month 6, 12, 18 and 24. Physical activity was assessed as an intermediate outcome by accelerometer (ActiGraph GT1M) for 1 week at baseline and the 6-, 12-, 18- and 24-month follow-up visits. The intervention effects were evaluated by a robust linear mixed model.

    RESULTS: In total, 188 subjects (64, 59, 65 in each group) were included. The mean (SD) age was 64 (7.7) years, BMI was 30.0 (4.4) kg/m2 and HbA1c was 50 (11) mmol/mol, 21% had prediabetes and 40% were female. The dropout rate was 11% at 24 months. Effect size (CI) for the primary outcome (HbA1c) ranged from -1.3 (-4.8 to 2.2) to 1.1 (-2.4 to 4.6) mmol/mol for the multi-component vs control group and from 0.3 (-3.3 to 3.9) to 3.1 (-0.5 to 6.7) mmol/mol for the single-component vs control group. Effect size (CI) for moderate-to-vigorous physical activity ranged from 8.0 (0.4 to 15.7) to 11.1 (3.3 to 19.0) min/day for the multi-component vs control group and from 7.6 (-0.4 to 15.6) to 9.4 (1.4 to 17.4) min/day for the single-component group vs control group.

    CONCLUSION: This 2-year intervention, including self-monitoring of steps with or without counselling, prevented a decrease in PA but did not provide evidence for improved metabolic control and cardiometabolic risk factors in a population with prediabetes or type 2 diabetes.

    TRIAL REGISTRATION: ClinicalTrials.gov, NCT02374788 . Registered 2 March 2015-Retrospectively registered.

    Download full text (pdf)
    fulltext
  • 35.
    Rossen, Jenny
    et al.
    Sophiahemmet University.
    Lööf, Helena
    Yngve, Agneta
    Hagströmer, Maria
    Brismar, Kerstin
    Johansson, Unn-Britt
    Sophiahemmet University.
    Support for self-management of physical activity in persons with prediabetes and type 2 diabetes: Experiences from Sophia Step Study2017Conference paper (Other academic)
  • 36.
    Rossen, Jenny
    et al.
    Sophiahemmet University.
    Lööf, Helena
    Sophiahemmet University.
    Yngve, Agneta
    Hagströmer, Maria
    Brismar, Kerstin
    Johansson, Unn-Britt
    Sophiahemmet University.
    'This is why I'm doing a lot of exercise': A qualitative study of participant's experiences of the Sophia Step Study2018In: International Diabetes Nursing, ISSN 2057-3316, E-ISSN 2057-3324Article in journal (Refereed)
    Abstract [en]

    Introduction: Support for physical activity (PA) is central in diabetes care. The Sophia Step Study is a three-armed randomised controlled trial aiming to evaluate different levels of support for increased PA in prediabetes and Type 2 diabetes. With the purpose to reveal the programme components and the mediating factors from the participants’ perspective this paper aims to report a qualitative exploration of adhering participants’ experiences after two years’ study participation.

    Methods: Semi-structured interviews were conducted with 18 participants (men, n = 11, women, n = 7, prediabetes, n = 5, Type 2 diabetes, n = 13, median age 68.5 years) who completed a two-year multi-component (n = 7), singlecomponent (n = 6) intervention or served as controls (n = 5) at a primary care center in Stockholm, Sweden. The interviews were analysed using content analysis with an inductive approach. Sophia Step Study is registered at ClinicalTrials.gov with Identifier: NCT02374788.

    Results: The participants recalled the frequent study assessments as providing feedback of health outcomes; positive reinforcement; a sense of sentinel and a personalised approach. Group meetings, pedometers and health check-ups were valued as resources for increased awareness and motivation of PA; establishment of new routines and control over the own health. The long program duration allowed for maintenance of awareness and routines for PA

    Conclusion: Adhering participants in theory-based interventions, but also in the control group, identified key mediators to support for PA. Feedback of results, personalised encouragement, emotional support and selfmonitoring should be regarded in self-management of PA to optimise patient motivation and outcomes.

    Download full text (pdf)
    fulltext
  • 37.
    Rossen, Jenny
    et al.
    Sophiahemmet University.
    Lööf, Helena
    Sophiahemmet University.
    Yngve, Agneta
    Sophiahemmet University.
    Hagströmer, Maria
    Brismar, Kerstin
    Johansson, Unn-Britt
    Sophiahemmet University.
    Using pedometers for self-management of physical activity: Participants' experiences from Sophia Step Study: A physical activity promotion intervention in pre- and type 2 diabetes2017Conference paper (Other academic)
  • 38.
    Rossen, Jenny
    et al.
    Sophiahemmet University.
    Von Rosen, Philip
    Johansson, Unn-Britt
    Sophiahemmet University.
    Brismar, Kerstin
    Hagströmer, Maria
    Sophiahemmet University.
    Associations of physical activity and sedentary behavior with cardiometabolic biomarkers in prediabetes and type 2 diabetes: A compositional data analysis2020In: Physician and sportsmedicine, ISSN 0091-3847, E-ISSN 2326-3660, Vol. 48, no 2, p. 222-228Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate the associations between objectively measured sedentary behavior (SB), light-intensity physical activity (LIPA) and moderate-to-vigorous physical activity (MVPA) and cardiometabolic and endocrine biomarkers, and to estimate the associations of reallocating time from one behavior to another with cardiometabolic and endocrine biomarkers.

    Methods: Baseline data from participants diagnosed with prediabetes or type 2 diabetes, n = 175, 58% men, mean (SD) age = 64.4 (7.7), recruited to a physical activity intervention was used. Time spent in SB, LIPA and MVPA was measured by accelerometer and transformed into isometric log-ratio coordinates. The associations between time spent in SB, LIPA and MVPA and biomarkers were examined by linear regression models. The change in each outcome of reallocating time between the three behaviors was estimated.

    Results: The findings show strong positive associations of time spent in MVPA and negative associations of time spent in SB relative to time spent in the other behaviors with sagittal abdominal diameter (SAD) and homeostasis model assessment for insulin resistance (HOMA-IR) and negative associations of time spent in SB with high-density lipoprotein (HDL) cholesterol. Theoretically, reallocation of 19 minutes MVPA to SB or to LIPA was associated with a 17% and 17% larger SAD, 39% and 36% larger HOMA-IR values and 3.3% and 2.3% lower levels of HDL, respectively.

    Conclusion: In conclusion, our analysis from a time-use perspective supports the current evidence that sedentary time is devastating for the cardiometabolic health. While LIPA probably requires more time, maintaining or increasing time in MVPA are the most important features of the time use behaviors when promoting a favorable cardiometabolic risk profile in adults with prediabetes and type 2 diabetes.

    Trial registration: ClinicalTrials.gov, NCT02374788. Registered 2 March 2015 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02374788.

  • 39.
    Rossen, Jenny
    et al.
    Sophiahemmet University.
    Yngve, Agneta
    Sophiahemmet University.
    Hagströmer, M
    Brismar, Kerstin
    Ainsworth, B
    Möller, P
    Iskull, C
    Johansson, Unn-Britt
    Sophiahemmet University.
    Sophia step study: An RCT using pedometers to increase daily steps in subjects with pre and type 2 diabetes2015Conference paper (Other academic)
  • 40. Svedbo Engström, Maria
    et al.
    Johansson, Unn-Britt
    Sophiahemmet University.
    Leksell, Janeth
    Linder, Ebba
    Eeg-Olofsson, Katarina
    Implementing the Digital Diabetes Questionnaire as a clinical tool in routine diabetes care: Focus group discussions with patients and health care professionals2022In: JMIR Diabetes, ISSN 2371-4379, Vol. 7, no 2, article id e34561Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The Diabetes Questionnaire is a digital patient-reported outcome and experience measure for adults living with diabetes. The Diabetes Questionnaire is intended for use in routine clinical visits in diabetes care and to enable patient perspectives to be integrated into the Swedish National Diabetes Register. The Diabetes Questionnaire was developed on the basis of patients' perspectives, and evidence for its measurement qualities has been demonstrated. Patients receive an invitation to complete the questionnaire before clinical visits, and the patient and health care professional (HCP) can discuss the findings, which are instantly displayed during the visit. Implementation processes for new tools in routine care need to be studied to understand the influence of contextual factors, the support needed, and how patients and HCPs experience clinical use.

    OBJECTIVE: The aim of this study was to describe patients' and HCPs' experiences of initiating the use of the digital Diabetes Questionnaire as a clinical tool in routine diabetes care, supported by a structured implementation strategy involving initial education, local facilitators, and regular follow-ups.

    METHODS: In this qualitative study, semistructured focus group discussions were conducted 12 months after the use of the Diabetes Questionnaire was initiated. Participants were diabetes specialist nurses and physicians (20 participants in 4 groups) at hospital-based outpatient clinics or primary health care clinics and adults with type 1 or type 2 diabetes (15 participants in 4 groups). The audiotaped transcripts were analyzed using inductive qualitative content analysis.

    RESULTS: The results revealed 2 main categories that integrated patients' and HCPs' experiences, which together formed an overarching theme: While implementation demands new approaches, the Diabetes Questionnaire provides a broader perspective. The first main category (The Diabetes Questionnaire supports person-centered clinical visits) comprised comments expressing that the digital Diabetes Questionnaire can initiate and encourage reflection in preparation for clinical visits, bring important topics to light during clinical visits, and broaden the scope of discussion by providing additional information. The second main category (The process of initiating the implementation of the Diabetes Questionnaire) comprised comments that described differences in engagement among HCPs and their managers, challenges of establishing new routines, experiences of support during implementation, thoughts about the Diabetes Questionnaire, need to change local administrative routines, and opportunities and concerns for continued use.

    CONCLUSIONS: The Diabetes Questionnaire can broaden the scope of health data in routine diabetes care. While implementation demands new approaches, patients and HCPs saw potential positive impacts of using the questionnaire at both the individual and group levels. Our results can inform further development of implementation strategies to support the clinical use of the questionnaire.

    Download full text (pdf)
    fulltext
  • 41. Svedbo Engström, Maria
    et al.
    Johansson, Unn-Britt
    Sophiahemmet University.
    Linder, Ebba
    Leksell, Janeth
    Eeg-Olofsson, Katarina
    Att implementera Diabetesenkäten som kliniskt verktyg i diabetesvården: Erfarenheter från patienter, diabetessjuksköterskor och läkare2021Conference paper (Other academic)
  • 42. Svedbo Engström, Maria
    et al.
    Johansson, Unn-Britt
    Sophiahemmet University.
    Linder, Ebba
    Leksell, Janeth
    Eeg-Olofsson, Katarina
    Initiating the digital Diabetes Questionnaire as a tool in routine diabetes care: Patients' and professionals' perspectives captured in focus group discussions2021Conference paper (Other academic)
  • 43. Svedbo Engström, Maria
    et al.
    Leksell, Janeth
    Johansson, Unn-Britt
    Sophiahemmet University.
    Borg, Sixten
    Palaszewski, Bo
    Franzén, Stefan
    Gudbjörnsdottir, Soffia
    Eeg-Olofsson, Katarina
    Health-related quality of life and glycaemic control among adults with type 1 and type 2 diabetes: a nationwide cross-sectional study2019In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 17, no 1, article id 141Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Health-related quality of life and glycaemic control are some of the central outcomes in clinical diabetes care and research. The purpose of this study was to describe the health-related quality of life and assess its association with glycaemic control in adults with type 1 and type 2 diabetes in a nationwide setting.

    METHODS: In this cross-sectional survey, people with type 1 (n = 2479) and type 2 diabetes (n = 2469) were selected at random without replacement from the Swedish National Diabetes Register. Eligibility criteria were being aged 18-80 years with at least one registered test of glycated haemoglobin (HbA1c) the last 12 months. The generic 36-item Short Form version 2 (SF-36v2) was answered by 1373 (55.4%) people with type 1 diabetes and 1353 (54.8%) with type 2 diabetes.

    RESULTS: Correlation analyses showed weak correlations between scores on the SF-36v2 and glycaemic control for both diabetes types. After the participants were divided into three groups based on their levels of HbA1c, multivariate regression analyses adjusted for demographics, other risk factors and diabetes complications showed that among participants with type 1 diabetes, the high-risk group (≥70 mmol/mol/8.6%) had statistically significantly lower means in five out of eight domains of the SF-36v2 and the mental component summary measure, as compared with the well-controlled group (< 52 mmol/mol/6.9%). Among the participants with type 2 diabetes, the high-risk group had the lowest statistically significantly means in seven domains and both summary measures.

    CONCLUSIONS: Among people with type 1 and type 2 diabetes, adults with high-risk HbA1c levels have lower levels of health-related quality of life in most but not all domains of the SF-36v2. This finding was not explained by demographics, other risk factors, or diabetes complications. The weak individual-level correlations between HRQOL scores and levels of glycaemic control argues for the need to not focus exclusively on either HbA1c levels or HRQOL scores but rather on both because both are important parts of a complex, life-long, challenging condition.

    Download full text (pdf)
    fulltext
  • 44. Svedbo Engström, Maria
    et al.
    Leksell, Janeth
    Johansson, Unn-Britt
    Sophiahemmet University.
    Borg, Sixten
    Palaszewski, Bo
    Franzén, Stefan
    Gudbjörnsdottir, Soffia
    Eeg-Olofsson, Katarina
    New Diabetes Questionnaire to add patients' perspectives to diabetes care for adults with type 1 and type 2 diabetes: Nationwide cross-sectional study of construct validity assessing associations with generic health-related quality of life and clinical variables2020In: BMJ Open, E-ISSN 2044-6055, Vol. 10, no 11, article id e038966Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To study evidence for construct validity, the aim was to describe the outcome from the recently developed Diabetes Questionnaire, assess the associations of that outcome with clinical variables and generic health-related quality of life, and study the sensitivity to differences between clinically relevant groups of glycaemic control in adults with type 1 and type 2 diabetes in a nation-wide setting.

    DESIGN: Cross-sectional survey.

    SETTING: Swedish diabetes care clinics connected to the National Diabetes Register (NDR).

    PARTICIPANTS: Among 2479 adults with type 1 diabetes and 2469 with type 2 diabetes selected at random from the NDR, 1373 (55.4%) with type 1 and 1353 (54.8%) with type 2 diabetes chose to participate.

    OUTCOME MEASURES: The Diabetes Questionnaire, the generic 36-item Short Form version 2 (SF-36v2) health survey and clinical variables.

    RESULTS: Related to the prespecified assumptions, supporting evidence for construct validity for the Diabetes Questionnaire was found. Supporting divergent validity, the statistically significant correlations with the clinical variables were few and weak. In relation to the SF-36v2 and in support of convergent validity, the strongest correlations were seen in the Diabetes Questionnaire scales General Well-being and Mood and Energy. In those scales, machine learning analyses showed that about 40%-45% of the variance was explained by the SF-36v2 results and clinical variables. In multiple regression analyses among three groups with differing levels of glycated haemoglobin adjusted for demographics, other risk factors, and diabetes complications, the high-risk group had, in support of sensitivity to clinically relevant groups, statistically significant lower scores than the well-controlled group in most Diabetes Questionnaire scales.

    CONCLUSIONS: This nation-wide study shows that the Diabetes Questionnaire captures some generic health-related quality-of-life dimensions, in addition to adding diabetes-specific information not covered by the SF-36v2 and clinical variables. The Diabetes Questionnaire is also sensitive to differences between clinically relevant groups of glycaemic control.

    Download full text (pdf)
    fulltext
  • 45. Svedbo Engström, Maria
    et al.
    Leksell, Janeth
    Johansson, Unn-Britt
    Sophiahemmet University.
    Eeg-Olofsson, Katarina
    Borg, Sixten
    Palaszewski, Bo
    Gudbjörnsdottir, Soffia
    A disease-specific questionnaire for measuring patient-reported outcomes and experiences in the Swedish National Diabetes Register: Development and evaluation of content validity, face validity, and test-retest reliability2018In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 101, no 1, p. 139-146Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To describe the development and evaluation of the content and face validity and test-retest reliability of a disease-specific questionnaire that measures patient-reported outcomes and experiences for the Swedish National Diabetes Register for adult patients who have type 1 or type 2 diabetes.

    METHODS: In this methodological study, a questionnaire was developed over four phases using an iterative process. Expert reviews and cognitive interviews were conducted to evaluate content and face validity, and a postal survey was administered to evaluate test-retest reliability.

    RESULTS: The expert reviews and cognitive interviews found the disease-specific questionnaire to be understandable, with relevant content and value for diabetes care. An item-level content validity index ranged from 0.6-1.0 and a scale content validity/average ranged from 0.7-1.0. The fourth version, with 33 items, two main parts and seven dimensions, was answered by 972 adults with type 1 and type 2 diabetes (response rate 61%). Weighted Kappa values ranged from 0.31-0.78 for type 1 diabetes and 0.27-0.74 for type 2 diabetes.

    CONCLUSIONS: This study describes the initial development of a disease-specific questionnaire in conjunction with the NDR. Content and face validity were confirmed and test-retest reliability was satisfactory.

    PRACTICE IMPLICATIONS: With the development of this questionnaire, the NDR becomes a clinical tool that contributes to further understanding the perspectives of adult individuals with diabetes.

  • 46. Svedbo Engström, Maria
    et al.
    Leksell, Janeth
    Johansson, Unn-Britt
    Sophiahemmet University.
    Gudbjörnsdottir, Soffia
    Development of a patient reported outcome measure for the Swedish national diabetes register2016Conference paper (Other academic)
  • 47.
    Svedbo Engström, Maria
    et al.
    Högskolan Dalarna.
    Leksell, Janeth
    Högskolan Dalarna.
    Johansson, Unn-Britt
    Sophiahemmet University.
    Gudbjörnsdóttir, Soffia
    Göteborgs universitet.
    Utveckling av patientrapporterade utfallsmått (PROM) för NDR. I: Nationella Diabetesregistret - Årsrapport 2012 års resultat2013Other (Other academic)
  • 48.
    Wijk, Ingrid
    et al.
    Sophiahemmet University.
    Amsberg, S
    Johansson, Unn-Britt
    Sophiahemmet University.
    Livheim, F
    Toft, E
    Anderbro, T
    Impact of an Acceptance and Commitment Therapy programme on HbA1c, self-management and psychosocial factors in adults with type 1 diabetes and elevated HbA1c levels: A randomised controlled trialManuscript (preprint) (Other academic)
  • 49.
    Wijk, Ingrid
    et al.
    Sophiahemmet University.
    Amsberg, Susanne
    Andreassen Gleissman, Sissel
    Sophiahemmet University.
    Toft, Eva
    Anderbro, Therese
    Johansson, Unn-Britt
    Sophiahemmet University.
    Living with type 1 diabetes as experienced by adults with prolonged elevated HbA1c: A qualitative study2023In: Diabetes Therapy, ISSN 1869-6953, E-ISSN 1869-6961Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: High HbA1c levels in type 1 diabetes (T1D) are associated with increased risk of micro- and macrovascular complications and severe diabetes distress. A more comprehensive understanding of the adult perspective of living with T1D can improve the quality of care. We aimed to describe experiences of living with T1D as an adult with prolonged elevated HbA1c.

    METHODS: Thirteen adults with T1D and HbA1c > 60 mmol/mol (7.6%) for at least 1 year were individually interviewed via a digital platform. The interviews were transcribed verbatim and analyzed using qualitative content analysis.

    RESULTS: The analysis identified an overarching theme, "a lifelong follower", and generated two main categories describing study participants' experience: constraining and manageable. Constraining experiences were explained in obligated control, loss of control, environmental impact, and consequences of diabetes. Manageable experiences were described in everyday life, approach to diabetes, and support in life. Diabetes knowledge in health care and in the general public, and individualized care were important factors in feeling understood, safe, and supported.

    CONCLUSIONS: The findings revealed the diverse experiences of adults with prolonged elevated HbA1c. Living with T1D, a lifelong non-chosen follower, could be perceived as constraining but manageable in different degrees. A person-centered care approach addressing both dimensions may be beneficial. Experiences of living with and managing diabetes are multifaceted and intertwined with life context and medical prerequisites.

    Download full text (pdf)
    fulltext
  • 50.
    Wijk, Ingrid
    et al.
    Sophiahemmet University.
    Amsberg, Susanne
    Johansson, Unn-Britt
    Sophiahemmet University.
    Toft, Eva
    Hagquist, Curt
    Anderbro, Therese
    Psychometric evaluation of the Swedish Acceptance and Action Diabetes Questionnaire: A Rasch analysis2023In: Journal of Nursing Measurement, ISSN 1061-3749, E-ISSN 1945-7049, article id JNM-2022-0071.R1Article in journal (Refereed)
    Abstract [en]

    Background and purpose: The Acceptance and Action Diabetes Questionnaire (AADQ) is a tool for assessing the acceptance of thoughts and emotions related to diabetes in people living with the disease. This study aimed to examine the psychometric properties of the Swedish version of AADQ (Swe-AADQ) in a sample of adults with type 1 diabetes.

    Methods: To examine the psychometric properties of the Swe-AADQ, the Rasch model was used. Data for 120 individuals were included.

    Results: The Swe-AADQ showed an acceptable fit to the Rasch model. A sufficiently high value of the separation index indicated a capacity to distinguish between different levels of acceptance in the sample. The seven-point Likert scale was reduced to three categories suggesting an improvement in the ordering of the item thresholds.

    Conclusions: The Swe-AADQ possesses reasonable quality in terms of reliability and validity. However, there are some deficiencies regarding the categorization of the response rating that should be addressed.

    Download full text (pdf)
    fulltext
1 - 50 of 50
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf