Anh Thi Tran

• Carlsen, Monica H.; Totland, Torunn Holm; Kumar, Radhika; Lensnes, Therese Margrethe Lysell; Sharma, Archana & Suntharalingam, A. Anita [Show all 9 contributors for this article] (2024). Evaluation of a digital FFQ using 24 h recalls as reference method, for assessment of habitual diet in women with South Asian origin in Norway. Public Health Nutrition (PHN). ISSN 1368-9800. 27(1). doi: 10.1017/S1368980024000302. Full text in Research Archive Show summary

  Objective: Dietary assessment tools should be designed for the target population. We developed an FFQ designed to assess diet in South Asian women in Norway. The study objective was to evaluate this FFQ using 24-h dietary recalls as reference method. Design: Approximately 3 weeks after the participants (n 40) had filled in the FFQ, the first of three non-consecutive 24-h dietary recalls was completed. The recalls were telephone-based, unannounced and performed by a trained dietitian, with 2–3 weeks between each interview. Setting: The DIASA 1 study, in Oslo, Norway. Participants: Women of South Asian ethnic origin participating in the DIASA 1 study were invited to participate in the evaluation study. Results: The WebFFQasia significantly overestimated the absolute intake of energy, protein, fat and carbohydrates compared with the 24-h dietary recalls. Absolute intakes of sugar, starch and fibre did not differ significantly between the methods. For energy percentages (E%), there were no significant differences, except for monounsaturated fat. Correlations were strong for E% from sugar and saturated fat and moderate for E% from fibre, carbohydrate, total fat and protein. Fourteen food groups out of twenty three were not significantly different compared with the reference method, and sixteen groups showed strong to moderate correlations. Conclusion: The WebFFQasia may be used to assess E% from habitual diet and can adequately estimate intakes and rank participants according to nutrient intake and main food categories at group level.

• Sharma, Archana; Nermoen, Ingrid; Qvigstad, Elisabeth; Tran, Anh Thi; Sommer, Christine & Sattar, Naveed [Show all 10 contributors for this article] (2022). High prevalence and significant ethnic differences in actionable HbA1C after gestational diabetes mellitus in women living in Norway. BMC Medicine. 20(1), p. 1–10. doi: 10.1186/s12916-022-02515-w. Full text in Research Archive Show summary

  Background The type 2 diabetes risk after gestational diabetes mellitus (GDM) is twice as high in South Asian compared to European women. Current guidelines differ regarding which test to use as a screening-tool post-GDM. We aimed to identify ethnic differences in the prevalence rates and early predictors for actionable HbA1c (defined as prediabetes and diabetes) short time after GDM. Methods This cross-sectional study, enrolling South Asian and Nordic women 1–3 years after a diagnosis of GDM, was undertaken at three hospitals in Norway. We performed a clinical and laboratory evaluation including an oral glucose tolerance test (OGTT). Medical records were used to retrieve data during pregnancy. Prediabetes was classified with HbA1c alone or combined with OGTT glucose measurements according to the WHO, WHO-IEC, and ADA criteria (fasting plasma glucose (FPG) 6.1–6.9 mmol/L, FPG 6.1–6.9 mmol/L and/or HbA1c 42-47 mmol/mol (6.0-6.4%), and FPG 5.6–6.9 mmol/L and/or HbA1c 39-47 mmol/mol (5.7-6.4%)). Ethnic differences in prevalence and predictors of glucose deterioration were assed by χ2 (Pearson) tests and logistic regression models. Results We included 163 South Asian and 108 Nordic women. Actionable HbA1c levels were highly prevalent and more so among South Asian than Nordic women (WHO-IEC-HbA1c: 25.8% vs. 6.5% (p ≤ 0.001), ADA-HbA1c: 58.3% vs. 22.2% (p ≤ 0.001)). Although adding OGTT-data gave higher combined prevalence rates of prediabetes and diabetes (WHO: 65.6% vs. 47.2% (p ≤ 0.05), WHO-IEC: 70.6% vs. 47.2% (p ≤ 0.001), ADA: 87.8% vs. 65.7% (p ≤ 0.001)), the excess risk in the South Asian women was best captured by the HbA1c. Important predictors for glucose deterioration after GDM were: South Asian ethnicity, GDM before the index pregnancy, use of glucose-lowering drugs in pregnancy, higher age, and higher in-pregnancy fasting glucose levels. Conclusions In women with GDM 1–3 year previously, we found high prevalence and significant ethnic differences in actionable ADA-HbA1c levels, with South Asian ethnicity, GDM before the index pregnancy, and the use of glucose-lowering drugs in pregnancy as the most important risk factors. This study reinforces the importance of annual screening—preferably with HbA1c measurements—to facilitate early intervention after GDM.

• Sharma, Archana; Birkeland, Kåre I.; Nermoen, Ingrid; Qvigstad, Elisabeth; Tran, Anh T. & Gulseth, Hanne L. [Show all 9 contributors for this article] (2021). Understanding mechanisms behind unwanted health behaviours in Nordic and South Asian women and how they affect their gestational diabetes follow-ups: A qualitative study. Diabetic Medicine. ISSN 0742-3071. 38(10), p. 1–12. doi: 10.1111/dme.14651. Full text in Research Archive Show summary

  Aims: The type 2 diabetes risk following gestational diabetes mellitus (GDM) is high, particularly among South Asian women in Western countries. Our study aimed to advance the knowledge regarding the mechanisms behind suboptimal follow-up in the Nordic and South Asian women with previous GDM by comparing (1) their experiences, (2) health and disease perceptions and (3) barriers to and facilitators of health-promoting behaviours. Methods: This qualitative study was conducted in three hospital outpatient clinics in Norway, comprising six focus group interviews with 28 women 1–3 years after a pregnancy with GDM. The participants were purposively sampled and grouped according to their ethnicity. The data were analysed using thematic analysis, and a theoretical approach was applied to support the analysis and discuss the study's findings. Results: Five main themes were identified: lack of resilience, emotional distress, ‘caught between a rock and a hard place’, postpartum abandonment and insufficient guidance. The key determinants of the maintenance of unwanted health behaviours after GDM were consistent across the ethnic groups. Although the importance of a culturally sensitive approach was emphasised, it appeared secondary to the need for a more organised public healthcare during and after GDM. Conclusions: Women's real-life constraints, combined with the inadequate healthcare-service implementation, could explain the non-adherence to the lifestyle-changes guidelines essential for preventing diabetes post-GDM. We suggest promoting specific coping strategies and changing the healthcare service approach rather than relying on women's capacity to initiate the necessary changes.

• Nøkleby, Kjersti; Berg, Tore Julsrud; Mdala, Ibrahimu; Tran, Anh Thi; Bakke, Åsne & Gjelsvik, Bjørn E. [Show all 12 contributors for this article] (2020). Variation between general practitioners in type 2 diabetes processes of care. Primary Care Diabetes. ISSN 1751-9918. 15(3), p. 1–7. doi: 10.1016/j.pcd.2020.11.018. Full text in Research Archive Show summary

  Aims To explore variation in general practitioners’ (GPs’) performance of six recommended procedures in type 2 diabetes patients <75 years without cardiovascular disease. Methods Cross-sectional study of quality of diabetes care in Norway based on electronic health records from 2014. GPs (clustered in practices) were divided in quintiles based on a composite measure of performance of six processes of care. We fitted a multilevel partial ordinal regression model to identify GP factors associated with being in quintiles with better performance. Results We identified 6015 type 2 diabetes patients from 275 GPs in 77 practices. The GPs performed on average 63.4% of the procedures; on average 46% in the poorest quintile to 81% in the best quintile with a larger range in individual GPs. After adjustments, use of a structured follow-up form was associated with GPs being in upper three quintiles (OR 12.4 (95% CI 2.37–65.1). Routines for reminders were associated with being in a better quintile (OR 2.6 (1.37–4.92). GPs’ age >60 years and heavier workload were associated with poorer performance. Conclusion We found large variations in GPs’ performance of processes of care. Factors reflecting structure and workload were strongly associated with performance.

• Tran, Anh Thi; Berg, Tore Julsrud; Mdala, Ibrahimu; Gjelsvik, Bjørn E.; Cooper, John & Sandberg, Sverre [Show all 8 contributors for this article] (2020). Factors associated with potential over- and undertreatment of hyperglycaemia and annual measurement of HbA<inf>1c</inf> in type 2 diabetes in norwegian general practice. Diabetic Medicine. ISSN 0742-3071. doi: 10.1111/dme.14500. Full text in Research Archive Show summary

  Aims To identify individual and general practitioner (GP) characteristics associated with potential over- and undertreatment of hyperglycaemia in type 2 diabetes and with HbA1c not being measured. Methods A cross-sectional study that included 10233 individuals with type 2 diabetes attending 282 GPs. Individuals with an HbA1c measurement during the last 15 months were categorized as potentially overtreated if they were prescribed a sulphonylurea and/or insulin when the HbA1c was less than 53 mmol/mol (7%) when aged over 75 years or less than 48 mmol/mol (6.5%) when aged between 65 and 75 years. Potential undertreatment was defined as age less than 60 years and HbA1c > 64 mmol/mol (8.0%) or HbA1c > 69 mmol/mol (8.5%) and treated with lifestyle modification and/or monotherapy. We used multilevel binary and multinominal logistic regression models to examine associations. Results Overall, 4.1% were potentially overtreated, 7.8% were potentially undertreated and 11% did not have HbA1c measured. Characteristics associated with potential overtreatment were as follows: long diabetes duration, prescribed antihypertensive medication, cardiovascular disease and renal failure. Potential undertreatment was associated with male gender, non-western origin and low educational level. Characteristics associated with not having an HbA1c measurement performed were male gender, age < 50 years and cardiovascular diseases. GP specialist status and GPs’ use of a Noklus diabetes application reduced the risk of not having an HbA1c measurement performed. Conclusion Potential overtreatment in elderly individuals with type 2 diabetes was relatively low. Nevertheless, appropriate de-intensification or intensification of treatment and regular HbA1c measurement in identified subgroups is warranted.

• Tran, Anh Thi; Berg, Tore Julsrud; Gjelsvik, Bjørn E.; Mdala, Ibrahimu; Thue, Geir & Cooper, John [Show all 11 contributors for this article] (2019). Ethnic and gender differences in the management of type 2 diabetes: a cross-sectional study from Norwegian general practice. BMC Health Services Research. 19:903, p. 1–11. doi: 10.1186/s12913-019-4557-4. Full text in Research Archive Show summary

  Background: Ethnic minority groups from Asia and Africa living in Western countries have a higher prevalence of type 2 diabetes (T2DM) than the general population. We aimed to assess ethnic differences in diabetes care by gender. Methods: Population-based, cross-sectional study identified 10,161 individuals with T2DM cared for by 282 General Practitioners (GP) in Norway. Ethnicity was based on country of birth. Multilevel regression models adjusted for individual and GP factors were applied to evaluate ethnic differences by gender. Results: Diabetes was diagnosed at a younger mean age in all other ethnic groups compared with Westerners (men: 45.9–51.6 years vs. 56.4 years, women: 44.9–53.8 years vs. 59.1 years). Among Westerners mean age at diagnosis was 2.7 years higher in women compared with men, while no gender difference in age at diagnosis was found in any minority group. Daily smoking was most common among Eastern European, South Asian and Middle East/North African men. In both genders, we found no ethnic differences in processes of care (GPs’ measurement of HbA1c, blood pressure, LDL-cholesterol, creatinine). The proportion who achieved the HbA1c treatment target was higher in Westerners (men: 62.3%; women: 66.1%), than in ethnic minorities (men 48.2%; women 53.5%). Compared with Western men, the odds ratio (OR) for achieving the target was 0.45 (95% CI 0.27 to 0.73) in Eastern European; 0.67 (0.51 to 0.87) in South Asian and 0.62 (0.43 to 0.88) in Middle Eastern/North African men. Compared with Western women, OR was 0.49 (0.28 to 0.87) in Eastern European and 0.64 (0.47 to 0.86) South Asian women. Compared with Westerners, the blood pressure target was more often achieved in South Asians and Middle Easterners/North Africans in both genders. Small ethnic differences in achieving the LDL-cholesterol treatment target by gender were found. Conclusion: Diabetes was diagnosed at a considerably earlier age in both minority men and minority women compared with Westerners. Several minority groups had worse glycaemic control compared with Westerners in both genders, which implies that it is necessary to improve glucose lowering treatment for the minority groups. Smoking cessation advice should particularly be offered to men in most minority groups.

• Gjelsvik, Bjørn E.; Tran, Anh Thi; Berg, Tore Julsrud; Bakke, Åsne; Mdala, Ibrahimu & Nøkleby, Kjersti [Show all 12 contributors for this article] (2019). Exploring the relationship between coronary heart disease and type 2 diabetes: a cross-sectional study of secondary prevention among diabetes patients. British Journal of General Practice Open. doi: 10.3399/bjgpopen18X101636. Full text in Research Archive Show summary

  Background: Coronary heart disease (CHD) and stroke are the major causes of death among people with diabetes. Aim: To describe the prevalence and onset of CHD and stroke among patients with type 2 diabetes mellitus (T2DM) in primary care in Norway, and explore the quality of secondary prevention. Design & setting: A cross-sectional study of data was undertaken from electronic medical records (EMRs) of 10 255 patients with T2DM in general practice. The study took place in five counties of Norway (Oslo, Akershus, Rogaland, Hordaland, and Nordland). Quality of care was assessed based on national guideline recommendations. Method: Summary statistics with adjustments and binary logistic regression models were used. Results: In total, 2260 patients (22.1%) had CHD and 759 (7.4%) had stroke. South Asians had significantly more CHD than ethnic Norwegians (29.5%, 95% confidence interval [CI] = 26.1 to 33.0 versus 21.5%, CI = 20.6 to 22.3) and other ethnic groups, and experienced onset of CHD or stroke at a mean of 7 years before Norwegians. In 47.9% of the patients, CHD was diagnosed before T2DM. Treatment target for low-density lipoprotein (LDL) cholesterol was reached for 30.0% and for systolic blood pressure (SBP) for 65.1% of the patients with CHD. Further, 20.9% of patients with CHD were present smokers, and only 5.0% of patients reached all four treatment targets (no smoking, HbA1c ≤7.0%, SBP <135 mmHg, LDL-cholesterol <1.8 mmol/l). Conclusion: The diagnosis of CHD preceded the diagnosis of T2DM in half of the patients. The prevalence of CHD was highest and onset earlier among ethnic South Asians. More intensive treatment of lipids, blood pressure, and smoking are needed in patients with T2DM and CHD.

• Bakke, Åsne; Tran, Anh Thi; Dalen, Ingvild; Cooper, John; Løvaas, Karianne Fjeld & Jenum, Anne Karen [Show all 15 contributors for this article] (2018). Population, general practitioner and practice characteristics are associated with screening procedures for microvascular complications in Type 2 diabetes care in Norway. Diabetic Medicine. ISSN 0742-3071. p. 1–13. doi: 10.1111/dme.13842. Full text in Research Archive
• Tran, Anh Thi; Bakke, Åsne; Berg, Tore Julsrud; Gjelsvik, Bjørn E.; Mdala, Ibrahimu & Nøkleby, Kjersti [Show all 13 contributors for this article] (2018). Are general practitioners characteristics associated with the quality of type 2 diabetes care in general practice? Results from the Norwegian ROSA4 study from 2014. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. 36(2), p. 170–179. doi: 10.1080/02813432.2018.1459238. Full text in Research Archive Show summary

  Objective: To explore the associations between general practitioners (GPs) characteristics such as gender, specialist status, country of birth and country of graduation and the quality of care for patients with type 2 diabetes (T2DM). Design: Cross-sectional survey. Setting and subjects: The 277 GPs provided care for 10082 patients with T2DM in Norway in 2014. The GPs characteristics were self-reported: 55% were male, 68% were specialists in General Practice, 82% born in Norway and 87% had graduated in Western Europe. Of patients, 81% were born in Norway and 8% in South Asia. Data regarding diabetes care were obtained from electronic medical records and manually verified. Main outcome measures: Performance of recommended screening procedures, prescribed medication and level of HbA1c, blood pressure and LDL-cholesterol stratified according to GPs characteristics, adjusted for patient and GP characteristics. Result: Female GPs, specialists, GPs born in Norway and GPs who graduated in Western Europe performed recommended procedures more frequently than their counterparts. Specialists achieved lower mean HbA1c (7.14% vs. 7.25%, p < 0.01), a larger proportion of their patients achieved good glycaemic control (HbA1c = 6.0%–7.0%) (49.1% vs. 44.4%, p = 0.018) and lower mean systolic blood pressure (133.0 mmHg vs. 134.7 mmHg, p < 0.01) compared with non-specialists. GPs who graduated in Western Europe achieved lower diastolic blood pressure than their counterparts (76.6 mmHg vs. 77.8 mmHg, p < 0.01). Conclusion: Several quality indicators for type 2 diabetes care were better if the GPs were specialists in General Practice.

• Bakke, Åsne; Cooper, John; Thue, Geir; Skeie, Svein; Carlsen, Siri & Dalen, Ingvild [Show all 15 contributors for this article] (2017). Type 2 diabetes in general practice in Norway 2005-2015: moderate improvements in risk factor control, but still major gaps in complication screening. BMJ Open Diabetes Research & Care. 5(1). doi: 10.1136/bmjdrc-2017-000459. Full text in Research Archive Show summary

  Objective: To assess the status of type 2 diabetes care in general practice and changes in the quality of care between 2005 and 2014, and to identify areas of diabetes care requiring improvement. Research design and methods: Two cross-sectional surveys were performed that included patients with type 2 diabetes in selected areas (n=9464 in 2014, n=5463 in 2005). Quality of care was assessed based on key recommendations in national guidelines. Differences in clinical performance between 2005 and 2014 were assessed in regression models adjusting for age, sex, counties and clustering within general practices. Results: Treatment targets were achieved in a higher proportion of patients in 2014 compared with 2005: hemoglobin A1c ≤7.0% (≤53 mmol/mol) in 62.8% vs 54.3%, blood pressure ≤135/80 mm Hg in 44.9% vs 36.6%, and total cholesterol ≤4.5 mmol/L in 49.9% vs 33.5% (all adjusted P≤0.001). Regarding screening procedures for microvascular complications, fewer patients had recorded an eye examination (61.0% vs 71.5%, adjusted P<0.001), whereas more patients underwent monofilament test (25.9% vs 18.7%, adjusted P<0.001). Testing for albuminuria remained low (30.3%) in 2014. A still high percentage were current smokers (22.7%). Conclusions: We found moderate improvements in risk factor control for patients with type 2 diabetes in general practice during the last decade, which are similar to improvements reported in other countries. We report major gaps in the performance of recommended screening procedures to detect microvascular complications. The proportion of daily smokers remains high. We suggest incentives to promote further improvements in diabetes care in Norway.

• Nosrati, Elias; Jenum, Anne Karen; Tran, Anh Thi; Marmot, Michael & King, Peter Laurence (2017). Ethnicity and place: the geography of diabetes inequalities under a strong welfare state. European Journal of Public Health. ISSN 1101-1262. 28(1), p. 30–34. doi: 10.1093/eurpub/ckx119. Full text in Research Archive
• Tran, Anh Thi; Straand, Jørund; Dalen, Ingvild; Birkeland, Kåre I.; Claudi, Tor & Cooper, John [Show all 8 contributors for this article] (2013). Pharmacological primary and secondary cardiovascular prevention among diabetic patients in a multiethnic general practice population: still room for improvements. BMC Health Services Research. 13. doi: 10.1186/1472-6963-13-182. Full text in Research Archive Show summary

  Background Ethnic minority groups have higher prevalence of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). We assessed general practitioners’ (GPs’) performance with respect to the pharmacological prevention of CVD in patients with T2DM from different ethnic backgrounds in Oslo. Methods Of 1653 T2DM patients cared for by 49 GPs in 2005, 380 had a diagnosis of CVD. Ethnicity was categorized as Norwegian, South Asian and other. Risk factor levels, medication use, achievement of treatment targets (HbA1c ≤ 7.5%, systolic blood pressure (SBP) ≤ 140 mmHg, total cholesterol/HDL-cholesterol < 4) and therapeutic intensity (number of drugs targeting each risk factor) were recorded. Chi-square, Wald tests and multiple linear regression analyses were used. Results Of the 1273 patients receiving primary prevention, 1.5% had their Hb1Ac, 4.8% SBP and 12.7% lipids levels above treatment thresholds without relevant prescriptions. Among patients on pharmacological therapy, 66% reached the HbA1c, 62% SBP and 62% lipid target. Proportions not achieving the HbA1c target were 26% in Norwegians, 38% in South Asians and 29% in others (p = 0.008). Proportions not achieving the SBP target were 42% in Norwegians, 22% in South Asians and 25% in others (p ≤ 0.001). Of those not achieving the HbA1c and SBP targets, 43% and 35% respectively, used only one agent. In secondary prevention, 0.8% of the patients had their HbA1c, 0.5% SBP and 7.4% lipid levels above treatment thresholds without relevant prescriptions. Among patients on pharmacological therapy, 65% reached the HbA1c, 64% SBP and 66% lipid target. Proportions not achieving the HbA1c target were 26% in Norwegians, 47% in South Asians and 40% in others (p = 0.03). Proportions not achieving the SBP target were 36% in Norwegians, 22% in South Asians and 56% in others (p = 0.050). Of those not achieving HbA1c and SBP targets, 49% and 21% respectively, were on mono-therapy. Conclusions Norwegian GPs comply reasonably well with guidelines for pharmacological prevention of CVD in T2DM patients across ethnic groups. However, lipid-lowering therapy was generally underused, and the achievement of treatment targets for HbA1c in ethnic minorities and for BP in Norwegians could be improved.

• Tran, Anh Thi; Straand, Jørund; Diep, Lien My; Meyer, Haakon; Birkeland, Kåre I. & Jenum, Anne Karen (2011). Cardiovascular disease by diabetes status in five ethnic minority groups compared to ethnic Norwegians. BMC Public Health. 11. doi: 10.1186/1471-2458-11-554. Full text in Research Archive Show summary

  Background The population in Norway has become multi-ethnic due to migration from Asia and Africa over the recent decades. The aim of the present study was to explore differences in the self-reported prevalence of cardiovascular disease (CVD) and associated risk factors by diabetes status in five ethnic minority groups compared to ethnic Norwegians. Methods Pooled data from three population-based cross-sectional studies conducted in Oslo between 2000 and 2002 was used. Of 54,473 invited individuals 24,749 (45.4%) participated. The participants self-reported health status, underwent a clinical examination and blood samples were drawn. A total of 17,854 individuals aged 30 to 61 years born in Norway, Sri-Lanka, Pakistan, Iran, Vietnam or Turkey were included in the study. Chi-square tests, one-way ANOVAs, ANCOVAs, multiple and logistic regression were used. Results Age- and gender-standardized prevalence of self-reported CVD varied between 5.8% and 8.2% for the ethnic minority groups, compared to 2.9% among ethnic Norwegians (p < 0.001). Prevalence of self-reported diabetes varied from 3.0% to 15.0% for the ethnic minority groups versus 1.8% for ethnic Norwegians (p < 0.001). Among individuals without diabetes, the CVD prevalence was 6.0% versus 2.6% for ethnic minorities and Norwegians, respectively (p < 0.001). Corresponding CVD prevalence rates among individuals with diabetes were 15.3% vs. 12.6% (p = 0.364). For individuals without diabetes, the odds ratio (OR) for CVD in the ethnic minority groups remained significantly higher (range 1.5-2.6) than ethnic Norwegians (p < 0.05), after adjustment for age, gender, education, employment, and body height, except for Turkish individuals. Regardless of diabetes status, obesity and physical inactivity were prevalent in the majority of ethnic minority groups, whereas systolic- and diastolic- blood pressures were higher in Norwegians. In nearly all ethnic groups, individuals with diabetes had higher triglycerides, waist-to-hip ratio (WHR), and body mass index compared to individuals without diabetes. Age, diabetes, hypertension, hypercholesterolemia, and WHR were significant predictors of CVD in both ethnic Norwegians and ethnic minorities, but significant ethnic differences were found for age, diabetes, and hypercholesterolemia. Conclusions Ethnic differences in the prevalence of CVD were prominent for individuals without diabetes. Primary CVD prevention including identification of undiagnosed diabetes should be prioritized for ethnic minorities without known diabetes.

• Tran, Anh Thi; Diep, Lien My; Cooper, John G; Claudi, Tor; Straand, Jørund & Birkeland, Kåre I. [Show all 8 contributors for this article] (2010). Quality of care for patients with type 2 diabetes in general practice according to patients' ethnic background: a cross-sectional study from Oslo, Norway. BMC Health Services Research. 10. doi: 10.1186/1472-6963-10-145. Full text in Research Archive Show summary

  Background In recent decades immigration to Norway from Asia, Africa and Eastern Europe has increased rapidly. The aim of this study was to assess the quality of care for type 2 diabetes mellitus (T2DM) patients from these ethnic minority groups compared with the care received by Norwegians. Methods In 2006, electronic medical record data were screened at 11 practices (49 GPs; 58857 patients). 1653 T2DM patients cared for in general practice were identified. Ethnicity was defined as self-reported country of birth. Chi-squared tests, one-way ANOVAs, multiple regression, linear mixed effect models and generalized linear mixed models were used. Results Diabetes was diagnosed at a younger age in patients from the ethnic minority groups (South Asians (SA): mean age 44.9 years, Middle East/North Africa (MENA): 47.2 years, East Asians (EA): 52.0 years, others: 49.0 years) compared with Norwegians (59.7 years, p < 0.001). HbA1c, systolic blood pressure (SBP) and s-cholesterol were measured in >85% of patients in all groups with minor differences between minority groups and Norwegians. A greater proportion of the minority groups were prescribed hypoglycaemic medications compared with Norwegians (≥79% vs. 72%, p < 0.001). After adjusting for age, gender, diabetes duration, practice and physician unit, HbA1c (geometric mean) for Norwegians was 6.9% compared to 7.3-7.5% in the minority groups (p < 0.05). The proportion with poor glycaemic control (HbA1c > 9%) was higher in minority groups (SA: 19.6%, MENA: 18.9% vs. Norwegians: 5.6%, p < 0.001. No significant ethnic differences were found in the proportions reaching the combined target: HbA1c ≤ 7.5%, SBP ≤ 140 mmHg, diastolic blood pressure (DBP) ≤ 85 mmHg and total s-cholesterol ≤5.0 mmol/L (Norwegians: 25.5%, SA: 24.9%, MENA: 26.9%, EA: 26.1%, others:17.5%). Conclusions Mean age at the time of diagnosis of T2DM was 8-15 years younger in minority groups compared with Norwegians. Recording of important processes of care measures is high in all groups. Only one in four of most patient groups achieved all four treatment targets and prescribing habits may be sub-optimal. Patients from minority groups have worse glycaemic control than Norwegians which implies that it might be necessary to improve the guidelines to meet the needs of specific ethnic groups.

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• Tran, Anh Thi (2020). Resultater fra ROSA 4-Studien: Påvirker etnisk bakgrunn og kjønn diabetesbehandling? Diabetesfag. ISSN 2535-5929. p. 26–28. Full text in Research Archive
• Tran, Anh Thi (2019). Potential over- and undertreatment in glycaemic management of type 2 diabetes in general practice in Norway. Full text in Research Archive
• Tran, Anh Thi (2019). ROSA4 resultater. Hva må til for å lykkes med behandlingen? Full text in Research Archive
• Tran, Anh Thi (2019). Diabetes blant innvandrere. Hvordan møte kulturelle og språklige utfordringer? Full text in Research Archive
• Tran, Anh Thi (2019). Innvandrere i ROSA 4-studien: Ulik sykdom, ulik behandling. Full text in Research Archive
• Tran, Anh Thi (2019). Type 2 diabetes care by ethnicity and gender. Full text in Research Archive
• Tran, Anh Thi (2019). Over- and undertreatment of type 2 diabetes. Full text in Research Archive
• Tran, Anh Thi (2019). Resultater fra ROSA 4-Studien: Kvalitetsforskjell på fastlegers behandling? Diabetesfag. ISSN 2535-5929. Full text in Research Archive
• Tran, Anh Thi (2018). Likeverdig behandling av pasienter med type 2 diabetes i norsk allmennpraksis? Full text in Research Archive
• Tran, Anh Thi; Gjelsvik, Bjørn E.; Berg, Tore Julsrud; Nøkleby, Kjersti; Cooper, John & Bakke, Åsne [Show all 10 contributors for this article] (2018). The influences of ethnicity on the quality of type 2 diabetes care in Norwegian general practice. Full text in Research Archive
• Tran, Anh Thi (2018). Type 2 diabetes hos innvandrere i Norge. Full text in Research Archive
• Tran, Anh Thi (2018). Behandling av type 2 diabetes hos minoriteter i Norge. [TV]. Diabetes kongress EASD 2018. Full text in Research Archive
• Bakke, Åsne; Cooper, John; Thue, Geir; Skeie, Svein; Carlsen, Siri & Dalen, Ingvild [Show all 14 contributors for this article] (2017). Type 2 diabetes in General Practice in Norway 2005-2014: Moderate improvements in risk Control but still major gaps in complication screening. Full text in Research Archive
• Tran, Anh Thi; Nøkleby, Kjersti & Jenum, Anne Karen (2017). Do General Practitioners characteristics matter in the quality of care for type 2 diabetes patients. Full text in Research Archive
• Bakke, Åsne; Cooper, John; Thue, Geir; Skeie, Svein; Carlsen, Siri & Dalen, Ingvild [Show all 15 contributors for this article] (2017). Type 2 Diabetes in General Practice in Norway 2005-2014: Moderate improvements in risk factor control but still major gaps in complication screening. Full text in Research Archive
• Tran, Anh Thi (2017). Diabetesbehandling for etniske minoriteter. Muligheter og utfordringer. Full text in Research Archive
• Tran, Anh Thi (2017). Diabetes, ethnicity and gender. Full text in Research Archive
• Tran, Anh Thi (2017). Kan jeg få diabetes? Full text in Research Archive
• Tran, Anh Thi (2017). Ethnic differences in quality of care for patients With type 2 diabetes in Norway. Full text in Research Archive
• Tran, Anh Thi (2017). Etterlevelse ved blodsukkersenkende legemiddelbehandling av type 2 diabetes. Diabetesforum. ISSN 1503-9609. Full text in Research Archive
• Tran, Anh Thi (2016). Patient education for non-Western immigrants with diabetes in Norway. Full text in Research Archive
• Tran, Anh Thi (2015). Diabetesbehandling og hjerte- og karsykdommer hos innvandrere i Oslo. Full text in Research Archive
• Tran, Anh Thi (2015). Etniske forskjeller i behandlingskvalitet for pasienter med type 2 diabetes. Full text in Research Archive
• Tran, Anh Thi (2015). Equitable care in diabetes. Full text in Research Archive
• Tran, Anh Thi (2015). Derfor har innvandrere mer diabetes. [Journal]. Oslo. Full text in Research Archive
• Tran, Anh Thi (2015). Diabetes og innvandrere i allmennpraksis. Full text in Research Archive
• Tran, Anh Thi (2015). Etniske forskjeller i behandlingskvalitet for pasienter med type 2 diabetes. Full text in Research Archive
• Tran, Anh Thi (2014). Hjerte- og karsykdommer, diabetes og etnisitet. Kvaliteten av diabetesbehandling i norsk allmennpraksis. Full text in Research Archive
• Tran, Anh Thi (2014). Diabetes epidemiologi. Hvordan fange opp risikopasienter. Full text in Research Archive
• Tran, Anh Thi (2014). Hjerte- og karsykdommer og diabetes hos innvandrere i Oslo. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. p. 134–134. Full text in Research Archive
• Tran, Anh Thi (2013). Forebyggende behandling hos pasienter med diabetes kan bli bedre. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. doi: 10.4045/tidskr13.1135. Full text in Research Archive
• Tran, Anh Thi (2013). Education for diabetes patients in praimary care with focus on immigrant patients. Living with diabetes. Full text in Research Archive
• Tran, Anh Thi (2013). Gruppeopplæring for pasienter med type 2 diabetes. Diabetesforum. ISSN 1503-9609. Full text in Research Archive
• Tran, Anh Thi (2012). Hjerte- og karsykdom og diabetes hos etniske minoriteter i Oslo. BestPractice Hjerte-karsykdommer: Faglig dialog mellom leger. p. 25–27. Full text in Research Archive
• Rønningen, Reidun & Tran, Anh Thi (2012). ”Å leve med diabetes”- Fokus på pasienter med innvandrerbakgrunn. Full text in Research Archive
• Tran, Anh Thi (2012). Diabetes og hjerte-karsykdommer, sosial ulikehet og etniske helseforskjeller. Full text in Research Archive
• Tran, Anh Thi; Straand, Jørund & Jenum, Anne Karen (2012). Over– og underbehandling av type 2 diabetes i allmennpraksis. Full text in Research Archive
• Tran, Anh Thi (2012). Etniske forskjeller på kvaliteten av diabetesbehandling i norsk allmennpraksis. BestPractice Diabetes. p. 20–21. Full text in Research Archive
• Tran, Anh Thi (2012). Diabetes og hjerte-karsykdommer, etniske helseforskjeller. Full text in Research Archive
• Jenum, Anne Karen & Tran, Anh Thi (2011). Forebygging og behandling hos etniske minoriteter-en utfordring for samfunnet og helsetjenesten. Diabetesforum. ISSN 1503-9609. p. 12–17. Full text in Research Archive
• Tran, Anh Thi; Straand, Jørund & Jenum, Anne Karen (2011). Prevensjon av hjerte og karsykdommer for etniske minoritets pasienter med tyep 2 diabetes. Full text in Research Archive
• Tran, Anh Thi (2011). Hjerte- og karsykdom vanligere hos innvandrere. www.tidsskriftet.no. p. 2212–2212. Full text in Research Archive
• Tran, Anh Thi (2011). Diabetes in immigrants and internationally. Full text in Research Archive
• Tran, Anh Thi (2011). Hjerte- og karsykdommer, diabetes og kvaliteten av diabetes behandling for ulike etniske grupper i Oslo. Full text in Research Archive
• Tran, Anh Thi; Steiner, Kristin H.; Wändell, Per E. & Jenum, Anne Karen (2011). Migration and health challenges-Diabetes and cardiovascular diseases in ethnic minorities. Full text in Research Archive
• Tran, Anh Thi; Jenum, Anne Karen & Straand, Jørund (2010). Ethnic differences in the risk for cardiovascular disease? Population survey from Oslo, Norway. Full text in Research Archive
• Tran, Anh Thi; Jenum, Anne Karen & Straand, Jørund (2010). How does ethnic background affect the risk for cardiovascular disease? Population survey from Oslo, Norway. Full text in Research Archive
• Tran, Anh Thi; Jenum, Anne Karen; Meyer, Haakon E; Birkeland, Kåre I. & Straand, Jørund (2010). Ethnic differences in the prevalence of cardiovascular disease and its risk factors in subjects with and without diabetes in Oslo, Norway. Full text in Research Archive
• Tran, Anh Thi; Jenum, Anne Karen & Straand, Jørund (2009). ”Diabetes og hjerte-kar sykdommer i ulike etniske grupper i Oslo”. Full text in Research Archive
• Tran, Anh Thi; Jenum, Anne Karen & Straand, Jørund (2009). “Ethnic differences in quality of diabetes care in general practice in Oslo”. Full text in Research Archive
• Tran, Anh Thi; Jenum, Anne Karen; Cooper, John G; Claudi, Tor; Hausken, MF & Ingskog, Wibeche [Show all 7 contributors for this article] (2009). “Does diabetic patients’ ethnic background influence quality of care received in general practice?”. Full text in Research Archive Show summary

  European General Practice Research Network meeting. Bertinoro (Italy), May 7-10th. 2009 Book of abstracts p 55.

• Tran, Anh Thi; Jenum, Anne Karen; Cooper, J.; Claudi, Tor; Ingskog, Wibeche & Hausken, MF [Show all 7 contributors for this article] (2008). Kvaliteten av diabetesomsorg i ulike etniske grupper i Oslo. (sammendrag fra muntlig presentasjon, Forskningsdagen PMU 2008). Utposten. ISSN 0800-5680. 37(6), p. 41–41. Full text in Research Archive
• Tran, Anh Thi; Jenum, Anne Karen; Cooper, JG; Claudi, T; Hausken, MF & Ingskog, Wibeche [Show all 7 contributors for this article] (2008). The impact of ethnicity on quality of care for diabetes in primary care measured by process indicators and intermediate outcomes. Diabetologia. ISSN 0012-186X. 51, p. S425–S426. Full text in Research Archive
• Tran, Anh Thi (2017). Diabetes hos etniske minoriteter i Norge. Diabetesforbundet. Full text in Research Archive

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