Gudbjörg Andresdottir | University of Copenhagen (original) (raw)

Papers by Gudbjörg Andresdottir

Diabetic Medicine, Mar 7, 2013

Aims Hydrogen sulphide levels are reduced in many disease states, including diabetes and end-stag... more Aims Hydrogen sulphide levels are reduced in many disease states, including diabetes and end-stage renal disease. We aimed to determine whether urinary sulphate excretion, as a proxy for hydrogen sulphide, was associated with progression of diabetic nephropathy. Methods We conducted a post-hoc study of a prospective, randomized, controlled trial on the effect of a low vs. normal protein diet for 4 years, on decline of renal function in patients with Type 1 diabetes and diabetic nephropathy. We excluded patients with less than three measurements of glomerular filtration rate assessed by 51 Cr-EDTA plasma clearance (GFR) and less than 1 year of follow-up (n = 10), leaving 72 patients eligible for analyses. We studied both association of rate of decline in GFR and association of the combined endpoint of end-stage renal disease and death with baseline 24-h urinary sulphate excretion. Results Sulphate excretion was significantly associated with the slope of GFR (r s =-0.28, P = 0.02). In a multivariate regression model, sulphate excretion was a significant determinant of decline in GFR, independent of age, gender, blood pressure, HbA 1c , smoking, albuminuria, baseline GFR and diet group (P < 0.01). In addition, adjusted r 2 increased from 5% in a model with the aforementioned risk factors to 22% when sulphate excretion was included in the model. Cox regression revealed a hazard ratio of 0.34 (95% CI 0.13-0.88, P = 0.026) for each natural log unit increase in urinary sulphate excretion. Conclusion High urinary sulphate excretion was significantly associated with slower decline in 51 Cr-EDTA-assessed GFR in diabetic nephropathy, independent of known progression promoters.

Journal of Hypertension, Sep 1, 2012

Hazard ratios per 1 SD increment (95% confi dence intervals) Diabetes Prediabetes Non-diabetes Nº... more Hazard ratios per 1 SD increment (95% confi dence intervals) Diabetes Prediabetes Non-diabetes Nº of participants 538 567 2413 Nº of endpoints (rate) * 29 (11.2) 22 (8.1) 55 (4.6)

Diabetologia, Sep 1, 2011

Kidney International, Feb 1, 2015

c l i n i c a l i n v e s t i g a t i o n G Andrésdóttir et al.: Improved prognosis of diabetic n... more c l i n i c a l i n v e s t i g a t i o n G Andrésdóttir et al.: Improved prognosis of diabetic nephropathy

Patient Preference and Adherence, Sep 1, 2015

Purpose: To explore the feasibility of a research-based program for patient-centered consultation... more Purpose: To explore the feasibility of a research-based program for patient-centered consultations to improve medical adherence and blood glucose control in patients with type 2 diabetes. Patients and methods: The patient-centered empowerment, motivation, and medical adherence (EMMA) consultation program consisted of three individual consultations and one phone call with a single health care professional (HCP). Nineteen patients with type 2 diabetes completed the feasibility study. Feasibility was assessed by a questionnaire-based interview with patients 2 months after the final consultation and interviews with HCPs. Patient participation was measured by 10-second event coding based on digital recordings and observations of the consultations. Results: HCPs reported that EMMA supported patient-centered consultations by facilitating dialogue, reflection, and patient activity. Patients reported that they experienced valuable learning during the consultations, felt understood, and listened to and felt a trusting relationship with HCPs. Consultations became more person-specific, which helped patients and HCPs to discover inadequate diabetes self-management through shared decision-making. Compared with routine consultations, HCPs talked less and patients talked more. Seven of ten dialogue tools were used by all patients. It was difficult to complete the EMMA consultations within the scheduled time. Conclusion: The EMMA program was feasible, usable, and acceptable to patients and HCPs. The use of tools elicited patients' perspectives and facilitated patient participation and shared decision-making.

Cardiovascular Diabetology, 2013

Background: Non-invasive measurements of 24 hour ambulatory central aortic systolic pressure (24 ... more Background: Non-invasive measurements of 24 hour ambulatory central aortic systolic pressure (24 h-CASP) and central pulse pressure (24 h-CPP) are now feasible. We evaluate the relationship between 24 h central blood pressure and diabetes-related complications in patients with type 1 diabetes. Methods: The study was cross-sectional, including 715 subjects: 86 controls (C), 69 patients with short diabetes duration (< 10 years), normoalbuminuria (< 30 mg/24 h) without receiving antihypertensive treatment (SN), 211 with longstanding diabetes (≥ 10 years) and normoalbuminuria (LN), 163 with microalbuminuria (30-299 mg/24 h) (Mi) and 186 with macroalbuminuria (> 300 mg/24 h) (Ma). 24 h-CASP and 24 h-CPP was measured using a tonometric wrist-watch-like device (BPro, HealthStats, Singapore) and derived using N-point moving average.

Patient Preference and Adherence, 2015

Purpose: To explore the feasibility of a research-based program for patient-centered consultation... more Purpose: To explore the feasibility of a research-based program for patient-centered consultations to improve medical adherence and blood glucose control in patients with type 2 diabetes. Patients and methods: The patient-centered empowerment, motivation, and medical adherence (EMMA) consultation program consisted of three individual consultations and one phone call with a single health care professional (HCP). Nineteen patients with type 2 diabetes completed the feasibility study. Feasibility was assessed by a questionnaire-based interview with patients 2 months after the final consultation and interviews with HCPs. Patient participation was measured by 10-second event coding based on digital recordings and observations of the consultations. Results: HCPs reported that EMMA supported patient-centered consultations by facilitating dialogue, reflection, and patient activity. Patients reported that they experienced valuable learning during the consultations, felt understood, and listened to and felt a trusting relationship with HCPs. Consultations became more person-specific, which helped patients and HCPs to discover inadequate diabetes self-management through shared decision-making. Compared with routine consultations, HCPs talked less and patients talked more. Seven of ten dialogue tools were used by all patients. It was difficult to complete the EMMA consultations within the scheduled time. Conclusion: The EMMA program was feasible, usable, and acceptable to patients and HCPs. The use of tools elicited patients' perspectives and facilitated patient participation and shared decision-making.

Journal of Hypertension, 2012

Hazard ratios per 1 SD increment (95% confi dence intervals) Diabetes Prediabetes Non-diabetes Nº... more Hazard ratios per 1 SD increment (95% confi dence intervals) Diabetes Prediabetes Non-diabetes Nº of participants 538 567 2413 Nº of endpoints (rate) * 29 (11.2) 22 (8.1) 55 (4.6)

Diabetic Medicine, 2013

AimsHydrogen sulphide levels are reduced in many disease states, including diabetes and end‐stage... more AimsHydrogen sulphide levels are reduced in many disease states, including diabetes and end‐stage renal disease. We aimed to determine whether urinary sulphate excretion, as a proxy for hydrogen sulphide, was associated with progression of diabetic nephropathy.MethodsWe conducted a post‐hoc study of a prospective, randomized, controlled trial on the effect of a low vs. normal protein diet for 4 years, on decline of renal function in patients with Type 1 diabetes and diabetic nephropathy. We excluded patients with less than three measurements of glomerular filtration rate assessed by 51Cr‐EDTA plasma clearance (GFR) and less than 1 year of follow‐up (n = 10), leaving 72 patients eligible for analyses. We studied both association of rate of decline in GFR and association of the combined endpoint of end‐stage renal disease and death with baseline 24‐h urinary sulphate excretion.ResultsSulphate excretion was significantly associated with the slope of GFR (rs = –0.28, P = 0.02). In a mul...

Diabetes Care, 2014

OBJECTIVE To evaluate long-term survival, development of renal end points, and decline in glomeru... more OBJECTIVE To evaluate long-term survival, development of renal end points, and decline in glomerular filtration rate (GFR) in patients with type 2 diabetes and diabetic nephropathy (DN) after renin-angiotensin system (RAS) inhibition and multifactorial treatment of cardiovascular risk factors have become standard of care. RESEARCH DESIGN AND METHODS All patients with type 2 diabetes and DN (n = 543) at the Steno Diabetes Center were followed during 2000–2010. GFR was measured yearly with 51Cr-EDTA plasma clearance. Annual decline in GFR was determined in patients with at least three measurements over a minimum of 3 years (∆GFR cohort, n = 286). Results were compared with historical data, obtained using identical criteria at our hospital, before implementation of current treatment guidelines. RESULTS Baseline mean (SD) GFR was 74 (32) mL/min/1.73 m2. More than 93% received RAS inhibition. During median 7.8 (interquartile range 5.7–9.8) years, mean (SE) annual GFR decline was 4.4 (0.2...

Cardiovascular Diabetology, 2013

Background: Non-invasive measurements of 24 hour ambulatory central aortic systolic pressure (24 ... more Background: Non-invasive measurements of 24 hour ambulatory central aortic systolic pressure (24 h-CASP) and central pulse pressure (24 h-CPP) are now feasible. We evaluate the relationship between 24 h central blood pressure and diabetes-related complications in patients with type 1 diabetes. Methods: The study was cross-sectional, including 715 subjects: 86 controls (C), 69 patients with short diabetes duration (< 10 years), normoalbuminuria (< 30 mg/24 h) without receiving antihypertensive treatment (SN), 211 with longstanding diabetes (≥ 10 years) and normoalbuminuria (LN), 163 with microalbuminuria (30-299 mg/24 h) (Mi) and 186 with macroalbuminuria (> 300 mg/24 h) (Ma). 24 h-CASP and 24 h-CPP was measured using a tonometric wrist-watch-like device (BPro, HealthStats, Singapore) and derived using N-point moving average.

Kidney International, 2015

c l i n i c a l i n v e s t i g a t i o n G Andrésdóttir et al.: Improved prognosis of diabetic n... more c l i n i c a l i n v e s t i g a t i o n G Andrésdóttir et al.: Improved prognosis of diabetic nephropathy

Diabetic Medicine, Mar 7, 2013

Aims Hydrogen sulphide levels are reduced in many disease states, including diabetes and end-stag... more Aims Hydrogen sulphide levels are reduced in many disease states, including diabetes and end-stage renal disease. We aimed to determine whether urinary sulphate excretion, as a proxy for hydrogen sulphide, was associated with progression of diabetic nephropathy. Methods We conducted a post-hoc study of a prospective, randomized, controlled trial on the effect of a low vs. normal protein diet for 4 years, on decline of renal function in patients with Type 1 diabetes and diabetic nephropathy. We excluded patients with less than three measurements of glomerular filtration rate assessed by 51 Cr-EDTA plasma clearance (GFR) and less than 1 year of follow-up (n = 10), leaving 72 patients eligible for analyses. We studied both association of rate of decline in GFR and association of the combined endpoint of end-stage renal disease and death with baseline 24-h urinary sulphate excretion. Results Sulphate excretion was significantly associated with the slope of GFR (r s =-0.28, P = 0.02). In a multivariate regression model, sulphate excretion was a significant determinant of decline in GFR, independent of age, gender, blood pressure, HbA 1c , smoking, albuminuria, baseline GFR and diet group (P < 0.01). In addition, adjusted r 2 increased from 5% in a model with the aforementioned risk factors to 22% when sulphate excretion was included in the model. Cox regression revealed a hazard ratio of 0.34 (95% CI 0.13-0.88, P = 0.026) for each natural log unit increase in urinary sulphate excretion. Conclusion High urinary sulphate excretion was significantly associated with slower decline in 51 Cr-EDTA-assessed GFR in diabetic nephropathy, independent of known progression promoters.

Journal of Hypertension, Sep 1, 2012

Hazard ratios per 1 SD increment (95% confi dence intervals) Diabetes Prediabetes Non-diabetes Nº... more Hazard ratios per 1 SD increment (95% confi dence intervals) Diabetes Prediabetes Non-diabetes Nº of participants 538 567 2413 Nº of endpoints (rate) * 29 (11.2) 22 (8.1) 55 (4.6)

Diabetologia, Sep 1, 2011

Kidney International, Feb 1, 2015

c l i n i c a l i n v e s t i g a t i o n G Andrésdóttir et al.: Improved prognosis of diabetic n... more c l i n i c a l i n v e s t i g a t i o n G Andrésdóttir et al.: Improved prognosis of diabetic nephropathy

Patient Preference and Adherence, Sep 1, 2015

Purpose: To explore the feasibility of a research-based program for patient-centered consultation... more Purpose: To explore the feasibility of a research-based program for patient-centered consultations to improve medical adherence and blood glucose control in patients with type 2 diabetes. Patients and methods: The patient-centered empowerment, motivation, and medical adherence (EMMA) consultation program consisted of three individual consultations and one phone call with a single health care professional (HCP). Nineteen patients with type 2 diabetes completed the feasibility study. Feasibility was assessed by a questionnaire-based interview with patients 2 months after the final consultation and interviews with HCPs. Patient participation was measured by 10-second event coding based on digital recordings and observations of the consultations. Results: HCPs reported that EMMA supported patient-centered consultations by facilitating dialogue, reflection, and patient activity. Patients reported that they experienced valuable learning during the consultations, felt understood, and listened to and felt a trusting relationship with HCPs. Consultations became more person-specific, which helped patients and HCPs to discover inadequate diabetes self-management through shared decision-making. Compared with routine consultations, HCPs talked less and patients talked more. Seven of ten dialogue tools were used by all patients. It was difficult to complete the EMMA consultations within the scheduled time. Conclusion: The EMMA program was feasible, usable, and acceptable to patients and HCPs. The use of tools elicited patients' perspectives and facilitated patient participation and shared decision-making.

Cardiovascular Diabetology, 2013

Background: Non-invasive measurements of 24 hour ambulatory central aortic systolic pressure (24 ... more Background: Non-invasive measurements of 24 hour ambulatory central aortic systolic pressure (24 h-CASP) and central pulse pressure (24 h-CPP) are now feasible. We evaluate the relationship between 24 h central blood pressure and diabetes-related complications in patients with type 1 diabetes. Methods: The study was cross-sectional, including 715 subjects: 86 controls (C), 69 patients with short diabetes duration (< 10 years), normoalbuminuria (< 30 mg/24 h) without receiving antihypertensive treatment (SN), 211 with longstanding diabetes (≥ 10 years) and normoalbuminuria (LN), 163 with microalbuminuria (30-299 mg/24 h) (Mi) and 186 with macroalbuminuria (> 300 mg/24 h) (Ma). 24 h-CASP and 24 h-CPP was measured using a tonometric wrist-watch-like device (BPro, HealthStats, Singapore) and derived using N-point moving average.

Patient Preference and Adherence, 2015

Purpose: To explore the feasibility of a research-based program for patient-centered consultation... more Purpose: To explore the feasibility of a research-based program for patient-centered consultations to improve medical adherence and blood glucose control in patients with type 2 diabetes. Patients and methods: The patient-centered empowerment, motivation, and medical adherence (EMMA) consultation program consisted of three individual consultations and one phone call with a single health care professional (HCP). Nineteen patients with type 2 diabetes completed the feasibility study. Feasibility was assessed by a questionnaire-based interview with patients 2 months after the final consultation and interviews with HCPs. Patient participation was measured by 10-second event coding based on digital recordings and observations of the consultations. Results: HCPs reported that EMMA supported patient-centered consultations by facilitating dialogue, reflection, and patient activity. Patients reported that they experienced valuable learning during the consultations, felt understood, and listened to and felt a trusting relationship with HCPs. Consultations became more person-specific, which helped patients and HCPs to discover inadequate diabetes self-management through shared decision-making. Compared with routine consultations, HCPs talked less and patients talked more. Seven of ten dialogue tools were used by all patients. It was difficult to complete the EMMA consultations within the scheduled time. Conclusion: The EMMA program was feasible, usable, and acceptable to patients and HCPs. The use of tools elicited patients' perspectives and facilitated patient participation and shared decision-making.

Journal of Hypertension, 2012

Hazard ratios per 1 SD increment (95% confi dence intervals) Diabetes Prediabetes Non-diabetes Nº... more Hazard ratios per 1 SD increment (95% confi dence intervals) Diabetes Prediabetes Non-diabetes Nº of participants 538 567 2413 Nº of endpoints (rate) * 29 (11.2) 22 (8.1) 55 (4.6)

Diabetic Medicine, 2013

AimsHydrogen sulphide levels are reduced in many disease states, including diabetes and end‐stage... more AimsHydrogen sulphide levels are reduced in many disease states, including diabetes and end‐stage renal disease. We aimed to determine whether urinary sulphate excretion, as a proxy for hydrogen sulphide, was associated with progression of diabetic nephropathy.MethodsWe conducted a post‐hoc study of a prospective, randomized, controlled trial on the effect of a low vs. normal protein diet for 4 years, on decline of renal function in patients with Type 1 diabetes and diabetic nephropathy. We excluded patients with less than three measurements of glomerular filtration rate assessed by 51Cr‐EDTA plasma clearance (GFR) and less than 1 year of follow‐up (n = 10), leaving 72 patients eligible for analyses. We studied both association of rate of decline in GFR and association of the combined endpoint of end‐stage renal disease and death with baseline 24‐h urinary sulphate excretion.ResultsSulphate excretion was significantly associated with the slope of GFR (rs = –0.28, P = 0.02). In a mul...

Diabetes Care, 2014

OBJECTIVE To evaluate long-term survival, development of renal end points, and decline in glomeru... more OBJECTIVE To evaluate long-term survival, development of renal end points, and decline in glomerular filtration rate (GFR) in patients with type 2 diabetes and diabetic nephropathy (DN) after renin-angiotensin system (RAS) inhibition and multifactorial treatment of cardiovascular risk factors have become standard of care. RESEARCH DESIGN AND METHODS All patients with type 2 diabetes and DN (n = 543) at the Steno Diabetes Center were followed during 2000–2010. GFR was measured yearly with 51Cr-EDTA plasma clearance. Annual decline in GFR was determined in patients with at least three measurements over a minimum of 3 years (∆GFR cohort, n = 286). Results were compared with historical data, obtained using identical criteria at our hospital, before implementation of current treatment guidelines. RESULTS Baseline mean (SD) GFR was 74 (32) mL/min/1.73 m2. More than 93% received RAS inhibition. During median 7.8 (interquartile range 5.7–9.8) years, mean (SE) annual GFR decline was 4.4 (0.2...

Cardiovascular Diabetology, 2013

Background: Non-invasive measurements of 24 hour ambulatory central aortic systolic pressure (24 ... more Background: Non-invasive measurements of 24 hour ambulatory central aortic systolic pressure (24 h-CASP) and central pulse pressure (24 h-CPP) are now feasible. We evaluate the relationship between 24 h central blood pressure and diabetes-related complications in patients with type 1 diabetes. Methods: The study was cross-sectional, including 715 subjects: 86 controls (C), 69 patients with short diabetes duration (< 10 years), normoalbuminuria (< 30 mg/24 h) without receiving antihypertensive treatment (SN), 211 with longstanding diabetes (≥ 10 years) and normoalbuminuria (LN), 163 with microalbuminuria (30-299 mg/24 h) (Mi) and 186 with macroalbuminuria (> 300 mg/24 h) (Ma). 24 h-CASP and 24 h-CPP was measured using a tonometric wrist-watch-like device (BPro, HealthStats, Singapore) and derived using N-point moving average.

Kidney International, 2015

c l i n i c a l i n v e s t i g a t i o n G Andrésdóttir et al.: Improved prognosis of diabetic n... more c l i n i c a l i n v e s t i g a t i o n G Andrésdóttir et al.: Improved prognosis of diabetic nephropathy