Danish Centre for Strategic Research in Type 2 Diabetes (DD2) project cohort of newly diagnosed patients with type 2 diabetes: a cohort profile

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Abstract

Purpose

The aim of this article is to provide a detailed description of the ongoing nationwide Danish Centre for Strategic Research in Type 2 Diabetes (DD2) project cohort and biobank. The DD2 cohort continuously enrols newly diagnosed patients with type 2 diabetes (T2D) throughout Denmark. The overall goal of the DD2 project is to establish a large and data-rich T2D cohort that can serve as a platform for exhaustive T2D research including (1) improved genotypic and phenotypic characterisation of T2D, (2) intervention studies of more individualised T2D treatment, (3) pharmacoepidemiological studies and (4) long-term follow-up studies on predictors of T2D complications and prognosis.

Participants

Between 2010 and 2016, 7011 individuals with T2D have been enrolled and assessed at baseline. Information collected include interview data (eg, body weight at age 20 years, physical activity and alcohol consumption), clinical examination data (eg, hip–waist ratio and resting heart rate) and biological samples (whole blood, DNA, plasma and urine) stored at −80°C and currently analysed for a range of biomarkers and genotypes.

Findings to date

Registry linkage has provided extensive supplemental continuous data on glycosylated haemoglobin A, lipids, albuminuria, blood pressure, smoking habits, body mass index, primary care contacts, hospital diagnoses and procedures, medication use, cancer and mortality. Cross-sectional associations between biomarkers, family history, anthropometric and lifestyle measures and presence of complications at baseline have been reported.

Future plans

During 2016, a detailed follow-up questionnaire has been answered by 85% of initial participants, providing follow-up information on baseline variables and on presence of diabetic neuropathy. The DD2 cohort has now been followed for a total of 18 862 person-years, and nested intervention trials and follow-up studies are ongoing. In the future, the cohort will serve as a strong national and international resource for recruiting patients to nested case studies, clinical trials, postmarketing surveillance, large-scale genome studies and follow-up studies of T2D complications.

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Most cited references 14

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The Danish Cancer Registry--history, content, quality and use.

H. Storm, E V Michelsen, I Clemmensen … (1997)

The Danish Cancer Registry is a population-based registry containing data on the incidence of cancer throughout Denmark since 1943. Reporting of cancer was made mandatory by administrative order in 1987. Details of individual cases of cancer are available according to the 7th revision of the International Classification of Diseases (ICD) for all years, and according to the ICD-O since 1978. A core data set is kept on each individual which includes date of birth, sex, date of cancer diagnosis, method of verification, date of death and cause of death. This paper describes the history of the registry, its data sources and its procedures, including quality control and access to data. Integration of both research activities and registration since the inception of the Registry has maintained the completeness and validity of the data for 1943-1996.

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Comparison of waist-to-hip ratio and other obesity indices as predictors of cardiovascular disease risk in people with type-2 diabetes: a prospective cohort study from ADVANCE.

Mark Woodward, , John Chalmers … (2011)

The aim of this study was to compare the strength of associations and discrimination capability of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) with cardiovascular disease risk in individuals with type-2 diabetes. Eleven thousand, one hundred and forty men and women were followed for a mean of 4.8 years. The Cox proportional hazard models were used to compute the hazard ratios and 95% confidence intervals (95% CI) for one standard deviation (SD) increase in baseline BMI (SD: 5 kg/m2), WC (SD: 13 cm) and WHR (SD: 0.08) with cardiovascular disease risk. After adjustment, hazard ratio (95% CI) for WC were 1.10 (1.03–1.18) for cardiovascular events, 1.13 (1.03–1.24) for coronary events, and 1.08 (0.98–1.19) for cardiovascular deaths. Estimates for WHR were 1.12 (1.05–1.19), 1.17 (1.08–1.28) and 1.19 (1.09–1.31). BMI was not related to any of these outcomes. Although the receiver operating characteristic curve could not differentiate between anthropometric variables (P values 0.24), the relative integrated discrimination improvement statistic showed an enhancement in the discrimination capabilities of models using WHR for cardiovascular outcomes, except for cerebrovascular events. Strengths of associations and discrimination statistics suggested that WHR was the best predictor of cardiovascular events and mortality in patients with type-2 diabetes and BMI the worst.

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Is Open Access

Nationwide trends in glucose-lowering drug use, Denmark, 1999–2014

Diana Hedevang Christensen, Jørgen Rungby, Reimar Wernich Thomsen (2016)

Purpose The objective of this study was to examine nationwide population-based time trends in the utilization of all glucose-lowering drugs in Denmark from 1999 to 2014. Methods Based on nationwide data from the Register of Medicinal Products Statistics, we retrieved sales statistics on glucose-lowering drugs and reported the total number of users and the prevalence of users per 1,000 inhabitants in 1-year intervals for all glucose-lowering drug classes. Results The annual prevalence of glucose-lowering drug users increased more than twofold from 19 per 1,000 inhabitants in 1999 (n=98,362) to 41 per 1,000 in 2014 (n=233,230). Metformin use increased more than sevenfold during the period and was used by 30 of 1,000 inhabitants in 2014, while the prevalence of insulin use increased 1.8-fold to 13 per 1,000 in 2014. After peaking in 2007, use of sulfonylurea halved to 6 per 1,000 in 2014. Newer drug classes including the glucagon-like peptide 1 receptor agonists, the dipeptidylpeptidase-4 inhibitors, and the sodium–glucose cotransporter 2 inhibitors had reached a considerable position by 2014, with 4 per 1,000, 6 per 1,000, and 0.8 per 1,000 inhabitants, respectively; however, the use of glucagon-like peptide 1 receptor agonists and sodium–glucose cotransporter 2 inhibitors in elderly people remained low. Thiazolidinediones decreased to virtually no use (0.03 per 1,000) in 2014. Conclusion The use of glucose-lowering drugs has doubled during 1999–2014. The pattern of glucose-lowering drug use has changed substantially reflecting the recommendations of metformin as first-line treatment. The newer glucose-lowering drug classes have been well received.

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Author and article information

Journal

Journal ID (nlm-ta): BMJ Open

Journal ID (iso-abbrev): BMJ Open

Journal ID (hwp): bmjopen

Journal ID (publisher-id): bmjopen

Title: BMJ Open

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Electronic): 2044-6055

Publication date Collection: 2018

Publication date (Electronic): 7 April 2018

Volume: 8

Issue: 4

Electronic Location Identifier: e017273

Affiliations

[1 ]departmentDepartment of Clinical Epidemiology , Aarhus University Hospital , Aarhus, Denmark

[2 ]departmentDiabetes Research Centre, Department of Endocrinology , Odense University Hospital , Odense, Denmark

[3 ]departmentDepartment of Pharmacology , University of Aarhus , Aarhus, Denmark

[4 ]departmentDepartment of Endocrinology , Bispebjerg, University Hospital Copenhagen , Copenhagen, Denmark

[5 ]departmentDepartment of Endocrinology , Odense Universitetshospital , Odense, Denmark

[6 ]departmentDepartment of Biochemistry , Lillebaelt Hospital , Vejle, Denmark

[7 ]departmentDepartment of Internal Medicine and Endocrinology , Aarhus University Hospital , Aarhus, Denmark

[8 ]departmentCardiovascular and Metabolic Disease (CVMD) Translational Medicine Unit, Early Clinical Development, IMED Biotech Unit , AstraZeneca , Gothenburg, Sweden

[9 ]departmentDepartment of Health Research & Policy (Epidemiology) , Stanford University , Stanford, California, USA

Author notes

[Correspondence to ] Dr Reimar Wernich Thomsen; rwt@ 123456clin.au.dk

Dr Jens Sandahl Christiansen died on 16 December 2015.

Author information

Reimar Wernich Thomsen http://orcid.org/0000-0001-9135-3474

Article

Publisher ID: bmjopen-2017-017273

DOI: 10.1136/bmjopen-2017-017273

PMC ID: 5892767

PubMed ID: 29627803

SO-VID: 1a9b475f-de93-4c73-a88f-e1820d521e08

License:

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

History

Date received : 20 April 2017

Date revision received : 12 February 2018

Date accepted : 02 March 2018

Funding

Funded by: Danish Agency for Science;

Funded by: Program for Clinical Research Infrastructure (PROCRIN);

Funded by: Danish Diabetes Association;

Funded by: FundRef http://dx.doi.org/10.13039/501100007324, Sundhedsstyrelsen;

Funded by: FundRef http://dx.doi.org/10.13039/501100004191, Novo Nordisk;

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ScienceOpen disciplines: Medicine

Keywords: general diabetes,epidemiology,genetics

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ScienceOpen disciplines: Medicine

Keywords: general diabetes, epidemiology, genetics

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Danish Centre for Strategic Research in Type 2 Diabetes (DD2) project cohort of newly diagnosed patients with type 2 diabetes: a cohort profile

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Purpose

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Future plans

Related collections

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Most cited references 14

The Danish Cancer Registry--history, content, quality and use.

Comparison of waist-to-hip ratio and other obesity indices as predictors of cardiovascular disease risk in people with type-2 diabetes: a prospective cohort study from ADVANCE.

Nationwide trends in glucose-lowering drug use, Denmark, 1999–2014

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