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J Hänninen

Publications and source records attributed to J Hänninen.

9 recordsLinked to original sources
PubMed2006

Insulin glargine or NPH combined with metformin in type 2 diabetes: the LANMET study.

AIMS/HYPOTHESIS: In type 2 diabetic patients we compared 9 months of combination therapy with insulin glargine and metformin with 9 months of NPH insulin combined with metformin. The primary focus was changes in HbA(1c); secondary focus was diurnal glucose profiles and symptomatic hypoglycaemia. METHODS: In this investigator-initiated open, parallel-group clinical trial involving seven centres, 110 insulin-naive type 2 diabetic patients with poor glycaemic control (HbA(1c) >or=8.0%) on oral hypoglycaemic agents (90% using sulfonylurea plus metformin) were randomised to receive bedtime insulin glargine with metformin (G+MET) or bedtime NPH with metformin (NPH+MET) for 36 weeks. The patients were taught how to self-adjust their insulin dose and use a modem to send the results of home glucose monitoring to treatment centres. The goal was to achieve a fasting plasma glucose (FPG) of 4.0 to 5.5 mmol/l in both groups. RESULTS: During the last 12 weeks, FPGs averaged 5.75+/-0.02 and 5.96+/-0.03 mmol/l (p<0.001) and insulin doses were 68+/-5 and 70+/-6 IU/day (0.69+/-0.05 and 0.66+/-0.04 IU kg(-1) day(-1), NS) in the G+MET and NPH+MET groups, respectively. At 36 weeks, mean HbA(1c) was 7.14+/-0.12 and 7.16+/-0.14%, respectively (NS). Symptomatic, but not confirmed symptomatic, hypoglycaemia was significantly lower during the first 12 weeks in the G+MET group (4.1+/-0.8 episodes/patient-year) than in the NPH+MET group (9.0+/-2.3 episodes/patient-year, p<0.05), but not significantly different thereafter. Glucose levels before dinner were higher in the NPH+MET group (10.1+/-0.3 mmol/l) than in the G+MET group (8.6+/-0.3 mmol/l, p=0.002) throughout the 36-week study. With regard to baseline characteristics such as initial glycaemia or C-peptide, there was no difference between patients who achieved good glycaemic control (HbA(1c) <7.0%) and those who did not. Differences were seen in the following: between study centres, weight gain during the run-in period and insulin therapy, and FPG during the last 12 weeks (5.7+/-0.2 vs 6.7+/-0.3 mmol/l for patients reaching vs those not reaching target, p<0.01). CONCLUSIONS/INTERPRETATION: Good glycaemic control can be achieved with both G+MET and NPH+MET. Use of G+MET reduces symptomatic hypoglycaemia during the first 12 weeks and dinner time hyperglycaemia compared with NPH+MET.

Adult↗
PubMed2001

Good continuity of care may improve quality of life in Type 2 diabetes.

Some features of diabetes care and diabetes treatment regimen which may have an impact on health-related quality of life (HRQOL) in people with diabetes were studied cross-sectionally using the SF-20 questionnaire. Of the 381 subjects with Type 2 diabetes aged under 65 years, 260 (68%) participated in the study. On univariate analysis, HRQOL was associated with regular clinical review (check-up at least twice a year) and continuity of care (the same GP for at least 2 years), education by a diabetes nurse, and satisfaction with diabetes education. No associations were found between the HRQOL dimensions and home glucose monitoring, participation in educational courses, or satisfaction with care. On logistic regression analysis only good continuity of care was significantly associated with the better well-being dimensions of the SF 20 (ORs 2.5-6.0). However, good continuity of care was also associated with less satisfactory glucose control (HbA(1c) 8.9 +/- 2.0 (+/- SD) vs 8.3 +/- 2.0%, P=0.04). It is concluded that a permanent physician-patient relationship may improve HRQOL in subjects with Type 2 diabetes, but further prospective studies are needed to confirm this finding.

Blood Glucose Self-Monitoring↗
PubMed2001

[Deadly tired].

Explore the source record for details and available documents.

Death↗
PubMed1999

Albuminuria and other risk factors for mortality in patients with non-insulin-dependent diabetes mellitus aged under 65 years: a population-based prospective 5-year study.

The overall 5-year mortality of non-insulin-dependent diabetes mellitus (NIDDM) patients aged under 65 years and associated risk factors were examined with a population-based study in a primary care setting. At the baseline, diabetic patients were asked of existing coronary heart disease (CHD) and hypertension, and checked for body mass index (BMI), glycemic control, lipid values and overnight albuminuria. Of 381 identified NIDDM patients, 252 (66%) participated in the study. The median age was 58 (range 36-64) years, BMI 30.5 (S.D. 5.5) kg/m2 and glycosylated hemoglobin A1c 8.7 (S.D. 2.0)%. Overall 5-year mortality was 8.3%. Factors associated with mortality were male gender, low high-density lipoprotein cholesterol, initial CHD and albuminuria > or = 20 microg/min. In Cox regression analysis, combination of CHD and albuminuria had the highest relative risk for mortality (RR = 3.43, 95% CI 1.63-7.19, P = 0.001), adjusted for gender and age. Albuminuria was associated with CHD only in male NIDDM patients. In primary health care, physicians should be aware that combination of CHD and (micro)albuminuria is a major predictor of mortality in NIDDM patients.

Adult↗
PubMed1998

Quality of life in NIDDM patients assessed with the SF-20 questionnaire.

The health-related quality of life (HRQOL) was studied in non-insulin-dependent diabetic (NIDDM) patients aged under 65 years, compared with age- and gender-matched controls, with the Medical Outcomes Study short-form (SF-20) general measure. Of 260 NIDDM patients and their 260 controls, 254 (98%) and 177 (68%), respectively, completed the SF-20. Among NIDDM patients, mean age was 56.3 (SD 6.9) years, BMI 30.4 (SD 5.5) kg/m2 and HbA1c 8.6% (SD 2.0%). The mean scores of six SF-20 dimensions were 11-27% lower in the NIDDM patients than in the controls (P < 0.01). Obesity, longer duration of diabetes, insulin treatment and impaired visual acuity were associated with poor HRQOL. In logistic regression analysis with the entire study population, existence of diabetes, coronary heart disease (CHD) and other macrovascular diseases were associated with impaired physical (OR 3.8-7.4), role (OR 2.2-2.8) and social (OR 2.2-2.8) functioning and health perception (OR 2.4-3.7). Diabetes was also associated with impaired mental health (OR 2.8). No associations were found between HRQOL and gender, age or marital status. NIDDM patients had significant and major impairments in HRQOL compared with non-diabetic controls, which were mainly due to macrovascular diseases.

Coronary Disease↗
PubMed1998

Population-based audit of non-insulin-dependent diabetic patients aged under 65 years in primary health care.

OBJECTIVE: To audit treatment of non-insulin-dependent diabetes mellitus (NIDDM). DESIGN: Cross-sectional, descriptive, population-based study. SETTING: Primary health care. SUBJECTS: NIDDM patients aged under 65 years in Mikkeli District, in eastern Finland. RESULTS: Of 381 (220 men) eligible NIDDM patients, 260 (141 men) participated (68%). Of subjects with at least two fasting blood glucose values > or = 6.7 mmol/l, diabetes diagnosis had been set to 63%. Eighty seven per cent had been annually checked up, and 36% had a satisfactory (< 7.5%) glycosylated haemoglobin A1c. Retinopathy, neuropathy and occasional microalbuminuria were detected in 13, 59 and 32% of patients, respectively. Patient education had been given to 85% of patients by the diabetes nurse. Of the patients, 79% were satisfied with the quality of diabetes education and care. MAIN OUTCOME MEASURES: Diagnostics of hyperglycaemia, regularity and continuity of care, metabolic control, complications, patient education and satisfaction. CONCLUSIONS: The metabolic control was poor among NIDDM patients in the study area. The diagnostics, regularity of care and the treatment of hyperglycaemia should be improved. Nevertheless, most patients were satisfied with both diabetes care and patient education.

Adult↗
PubMed1997

Effects of two histamine-N-methyltransferase inhibitors, SKF 91488 and BW 301 U, in rodent antinociception.

We have previously reported that the histaminergic system is involved in the control of pain perception, and that substances able to enhance histamine brain levels, such as the histamine-N-methyltransferase inhibitor, metoprine, induce antinociception. In the present study, in order to corroborate the idea of inducing antinociception by inhibiting histamine catabolism, the effects of a noncompetitive histamine-N-methyltransferase inhibitor. SKF 91488, were studied in rodents by means of tests inducing three different kinds of noxious stimuli: thermal (mouse hot plate), chemical (mouse abdominal constrictions) and mechanical (rat paw pressure). The ability to react to noxious stimuli was assessed by the rota-rod test. In addition, a competitive inhibitor of the histamine catabolism enzyme, BW 301 U, was studied in the hot plate test. SKF 91488 (30, 50 and 100 micrograms per animal i.c.v.) raised dose-dependently the pain threshold in all three tests. To verify whether SKF 91488-induced antinociception is due to inhibition of histamine-N-methyltransferase, (R)-alpha-methylhistamine, described to block histamine release and synthesis by stimulating the histamine H3-autoreceptor and activating the negative feed-back mechanism, was used. When administered at doses which do not alter the pain threshold per se, 0.5 microgram per rat i.c.v. or 10 mg kg-1 i.p. in mice, (R)-alpha-methylhistamine was able to antagonize significantly the antinociceptive effect induced by 30 micrograms per animal i.c.v. of SKF 91488. BW 301 U (30 and 100 mg kg-1 i.p.) showed a dose-dependent, long-lasting antinociception, which was also antagonized by pretreatment with (R)-alpha-methylhistamine. The present data show that the antinociceptive effect previously described for metoprine is not restricted to this molecule, but is also shared by other histamine-N-methyl-transferase inhibitors. This generalization provides further evidence to the importance of the histaminergic system in pain control mechanisms.

Analgesics↗