Objectives-To study prevalence and incidence of diabetes mellitus in patients with cystic fibrosis.Design-Five year prospective study with annual oral glucose tolerance tests.Setting-CF Center Copenhagen, Denmark. Subjects-191 patients with cystic fibrosis aged above 2 years.Main outcome measures-Glucose tolerance, plasma glucose concentrations after fasting and after glucose loading, and haemoglobin Al, levels.Results-Prevalence of diabetes increased from 11% (n=21) to 24% (n=46) during study, with annual age dependent incidence of 4-9V/.. Diabetes was diagnosed at median age of 21 (range 3-40). At diagnosis of diabetes, symptoms of hyperglycaemia were present in 33% of patients, fasting hyperglycaemia (>7.8 mmol/l) was seen in 16'!%, and increased haemoglobin A,, levels (> 6.4%/6) were seen in 16'/!. Impaired glucose tolerance implied higher risk for development ofdiabetes than normal glucose tolerance (odds ratio 5.6). In 58%1. of cases with impaired glucose tolerance, however, glucose tolerance was normal at next annual test. Normal glucose tolerance was found in only 37%. of patients at all five tests. Within this group of patients, median plasma glucose concentrations after fasting and after glucose loading and haemoglobin Alc levels increased by 6-8"/! during study.Conclusions-Prevalence and incidence of diabetes in cystic fibrosis patients was high and increased with age. Since hyperglycaemic symptoms, fasting hyperglycaemia, and increased levels of glycated haemoglobin did not reliably identify diabetes mellitus, we recommend annual oral glucose tolerance tests in all cystic fibrosis patients aged over 10 years.

Biochemical screenings are biased by diurnal variations, which must be considered when blood concentrations of these parameters are interpreted in the clinical setting.

BackgroundScreening programmes for type 2 diabetes inevitably find more individuals at high risk for diabetes than people with undiagnosed prevalent disease. While well established guidelines for the treatment of diabetes exist, less is known about treatment or prevention strategies for individuals found at high risk following screening. In order to make better use of the opportunities for primary prevention of diabetes and its complications among this high risk group, it is important to quantify diabetes progression rates and to examine the development of early markers of cardiovascular disease and microvascular diabetic complications. We also require a better understanding of the mechanisms that underlie and drive early changes in cardiometabolic physiology. The ADDITION-PRO study was designed to address these issues among individuals at different levels of diabetes risk recruited from Danish primary care.Methods/DesignADDITION-PRO is a population-based, longitudinal cohort study of individuals at high risk for diabetes. 16,136 eligible individuals were identified at high risk following participation in a stepwise screening programme in Danish general practice between 2001 and 2006. All individuals with impaired glucose regulation at screening, those who developed diabetes following screening, and a random sub-sample of those at lower levels of diabetes risk were invited to attend a follow-up health assessment in 2009–2011 (n = 4,188), of whom 2,082 (50%) attended. The health assessment included detailed measurement of anthropometry, body composition, biochemistry, physical activity and cardiovascular risk factors including aortic stiffness and central blood pressure. All ADDITION-PRO participants are being followed for incident cardiovascular disease and death.DiscussionThe ADDITION-PRO study is designed to increase understanding of cardiovascular risk and its underlying mechanisms among individuals at high risk of diabetes. Key features of this study include (i) a carefully characterised cohort at different levels of diabetes risk; (ii) detailed measurement of cardiovascular and metabolic risk factors; (iii) objective measurement of physical activity behaviour; and (iv) long-term follow-up of hard clinical outcomes including mortality and cardiovascular disease. Results will inform policy recommendations concerning cardiovascular risk reduction and treatment among individuals at high risk for diabetes. The detailed phenotyping of this cohort will also allow a number of research questions concerning early changes in cardiometabolic physiology to be addressed.

Link back to DTU OrbitCitation (APA): Kim, T., Hansen, A. M., & Branner, K. (2013 ABSTRACTIn this paper a new anisotropic beam finite element for composite wind turbine blades is developed and implemented into the aeroelastic nonlinear multibody code, HAWC2, intended to be used to investigate if use of anisotropic material layups in wind turbine blades can be tailored for improved performance such as reduction of loads and/or increased power capture. The element stiffness and mass matrices are first derived based on pre-calculated anisotropic beam properties, and the beam element is subsequently put into a floating frame of reference to enable full rigid body displacement and rotation of the beam. This derivation provides the mass and stiffness properties and the fictitious forces needed for implementation into HAWC2. The implementation is subsequently validated by running three validation cases which all show good agreement with results obtained by other authors. Further, a parametric study is conducted in order to investigate if the given anisotropic effect of the composite blade, bend-twist coupling effect, is able to be examined by the developed beam element in a multibody system or not. Two different coupled examples of bend-twist coupling for the blade of a 5MW fictitious wind turbine are considered. The two cases differ in the amount of bend-twist coupling introduced into the blade so that they produce 0.3deg and 1deg twist at the blade tip (towards feather), respectively, for a 1m flapwise tip deflection towards the tower. It is examined if the current structural model is able to capture the anisotropic effects in a multibody system.

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