Het Universitair DiabetesCentrum gaat binnenkort verhuizen. Vanaf 12 november vindt u in ons gebouw De Brug, op de begane grond. De gemakkelijkste ingang is nr. 47 aan de Oostersingel, zie de foto en de plattegrond. U loopt door de draaideur naar binnen, en vindt ons direct aan de linkerkant. Een bushalte is vlak in de buurt op de Oostersingel, of aan de hoofdingang van het UMCG.
Mensen die met de auto komen, parkeren het simpelst in garage Noord, en nemen dan trap of lift aan de noordelijke kant van de garage om pal naast het Diabetescentrum uit te komen. Ook uitermate comfortabel voor toegang voor mensen, die van een rolstoel afhankelijk zijn.
U vindt in de nieuwe locatie alle faciliteiten die belangrijk zijn voor uw zorg, en die u ook gewend was in het oude Triadegebouw: diabetesverpleegkundigen, diëtisten, podotherapeut, internisten, bloedafnamepunt, fundusfotografie, en de wetenschappelijk onderzoekers……
Gestational diabetes mellitus: diagnosis and outcome.
Need for a revision of the Dutch perspective?
PhD ceremony: S.H. Koning, MSc
When: November 27, 2017
Promotors: prof. dr. B.H.R. (Bruce) Wolffenbuttel, P.P. van den Berg
Where: Academy building RUG, open to the public
Faculty: Medical Sciences / UMCG
Untreated gestational diabetes mellitus (GDM) is associated with an increased risk of complications for both mother and child. Many of these complications can be reduced by early diagnosis and treatment of GDM. However, worldwide there is a lack of agreement on the best way to diagnose and treat GDM.
In the Netherlands, the Dutch Society of Obstetrics and Gynaecology guideline “Diabetes and Pregnancy” for the screening and treatment of GDM was implemented in 2010. The diagnostic thresholds are based on the old WHO consensus originating from 1999 and have until now not been updated to the newest (more stringent) criteria, implemented in 2013. These new criteria have been adopted by many expert committees. However, evidence that applying the stricter criteria for GDM improves pregnancy outcomes is limited.
The research described in this thesis aimed to evaluate the current Dutch national guideline of GDM i.e. what is the outcome of GDM pregnancies using this guideline? And what are consequences when the current diagnostic criteria of GDM are to be revised?
In this thesis we have shown that the currently used national guideline for screening and treatment of GDM is successful in reducing the risk of short-term adverse outcomes, but not in reducing the likelihood of having a large-for-gestational-age neonate. We have also shown that the long-term care for GDM is far from optimal and requires further improvement. In order to further optimize GDM care and pregnancy outcomes we advise the use of more stringent blood glucose criteria for GDM diagnosis.
Background: Early diagnosis and treatment of high blood pressure (BP) and cholesterol is important to reduce cardiovascular risk. We compared BP and LDL-cholesterol (LDL-C) as well as the quality of treatment between obese subjects and normal weight and overweight individuals.
Methods: 87,648 participants of the Lifelines study were categorised according to obesity (normal weight/ overweight/obesity) and age. Mean systolic BP and LDL-C were calculated depending on treatment, BMI, age and sex.
Results: In all age groups, except those aged 70-80 years, women had a significantly lower BP than men. Use of BP-lowering medication did not result in BP levels comparable with non-users, except in those aged 70-80 years. Despite medication, the BP was insufficiently controlled in 20-50% of participants. BP was significantly higher in obese vs. normal weight and overweight individuals of all ages, but most apparently in men younger than 50 years. Mean LDL-C varied between 2.5- .0 mmol/l. Despite higher statin use, obese participants had a higher LDL-C than those with a normal weight. Statins abolished the age-dependent LDL-C increase. Many participants did not achieve target LDL-C < 2.5 mmol/l. A small percentage of individuals treated with BP-lowering drugs were also using statins (overall 32% in men, 17% in women).
Conclusion: Obese individuals, especially men younger than 50, have a higher BP and LDL-C compared with those with overweight and a normal weight. Use of BP-lowering drugs did not revert the BP back to levels normal for the specific age and BMI group, whereas statins abolished the age-related increase in LDL-C. These data suggest that more attention is needed for active screening and treatment of cardiovascular risk factors.
Read the full article at: http://www.njmonline.nl/getpdf.php?id=1911
Introduction and aim: Insight into the total economic burden of diabetes mellitus (DM) is essential for decision makers and payers. Currently available estimates for the Netherlands only include part of the total burden or are no longer up-to-date. Therefore, this study aimed to determine the current total economic burden of DM and its complications in the Netherlands, by including all the relevant cost components.
Methods: The study combined a systematic literature review to identify all relevant published information and a targeted review to identify relevant information in the grey literature. The identified evidence was then combined to estimate the current total economic burden.
Results: In 2016, there were an estimated 1.1 million DM patients in the Netherlands, of whom approximately 10% had type 1 and 90% had type 2 DM. The estimated current total economic burden of DM was € 6.8 billion in 2016. Healthcare costs (excluding costs of complications) were € 1.6 billion, direct costs of complications were € 1.3 billion and indirect costs due to productivity losses, welfare payments and complications were € 4.0 billion.
Conclusion: DM and its complications pose a substantial economic burden to the Netherlands, which is expected to rise due to changing demographics and lifestyle. Indirect costs, such as welfare payments, accounted for a large portion of the current total economic burden of DM, while these cost components are often not included in cost estimations. Publicly available data for key cost drivers such as complications were scarce.
Read the full article at: http://www.njmonline.nl/getpdf.php?id=1883
Epidemiology of metabolic health
Lifestyle determinants and health-related quality of life
PhD ceremony: S.N. Slagter
When: January 11, 2017
Promotor: prof. dr. B.H.R. (Bruce) Wolffenbuttel
Where: Academy building RUG, open to the public.
Faculty: Medical Sciences / UMCG
Overweight and obesity often lead to the development of a disturbed glucose metabolism, increased blood pressure and a disturbed fat profile (too low values of the “good” HDL-cholesterol and high triglycerides values). This combination of metabolic complications is called the metabolic syndrome. It is associated with an increased risk of type 2 diabetes and cardiovascular diseases. Approximately one in four Europeans have the metabolic syndrome. Even though it is usually caused by obesity, a sub-group of obese people seem to be less susceptible to the metabolic health risks. They have an equally healthy metabolism as lean people. In the literature, this is referred to as metabolically healthy obese.
In ten large population studies from seven different European countries the occurrence of the metabolic syndrome and metabolically healthy obesity has been estimated. The metabolic syndrome is common in Europe and the Netherlands. However, in the Dutch LifeLines study still nearly 1 out of 4 obese women and 1 out of 10 obese men are metabolically healthy (depending on their age). From studies with LifeLines data only, it seems that smoking-, drinking-, eating- and exercise behaviours of these people is important. The level of tobacco use and drinking more than one alcoholic beverage per day was already related to the development of the metabolic syndrome. However, a ‘healthy’ dietary pattern and intensive vigorous physical activity increased in obese people the chance of metabolically healthy obesity. Actively changing lifestyle factors will reduce the number of people developing the metabolic syndrome, and consequently will reduce the incidence of type 2 diabetes and cardiovascular diseases. However, even before these more serious chronic conditions occur, obese subjects (without metabolic complications) had an impaired quality of life. Therefore, in the treatment of obesity it is advisable to take into account aspects relating to the quality of life.