Esben Selmer Buhl

• Tibelles, Hatuia Bø; Kirkebøen, Lars Johannessen; Jenum, Anne Karen; Straand, Jørund; Berg, Tore Julsrud & Buhl, Esben Selmer (2025). Young-onset type 2 diabetes and associations with high disability rate, low educational level and immigrant background: A study from Norwegian general practice. BMJ Open. 15(9). doi: 10.1136/bmjopen-2024-096521. Fulltekst i vitenarkiv
• Strandberg, Ragnhild Bjarkøy; Nilsen, Roy Miodini; Pouwer, Francois; Igland, Jannicke; Røssberg, Jan Ivar & Jenum, Anne Karen [Vis alle 8 forfattere av denne artikkelen] (2025). Pharmacologically treated depression, anxiety, and insomnia in individuals with type 2 diabetes: The role of diabetes duration, age, and age at diabetes onset. A Norwegian population-based registry study from the OMIT cohort. Journal of Psychosomatic Research. ISSN 0022-3999. 190, s. 1–8. doi: 10.1016/j.jpsychores.2025.112057. Fulltekst i vitenarkiv Vis sammendrag

  Objective To examine whether type 2 diabetes (T2D) duration (‘0–4’; ‘≥5–9’; ≥10–19′; ‘≥20 years') was associated with use of medication for depression, anxiety, or insomnia, and if possible associations were modified by age, age at T2D onset, sex, and education. Methods We used data from 55,083 adults with T2D in the national registry-based cohort study Outcomes & Multi-morbidity In T2D (2006–2019). Adjusted associations and effect modifications were estimated using binary logistic regressions with generalized estimation equations in the subgroups age (<60, ≥60 years), age at diabetes onset (<40, ≥40 years), sex (men, women), and education (primary, high school, university). Results At initial registration, 12 % used medication for depression, 10 % for anxiety, and 16 % for insomnia. These prevalence estimates increased with diabetes duration in most subgroups. Individuals with early onset T2D had higher prevalence of depression than those with late onset, which increased with diabetes duration (per category change diabetes duration 0.7 % (95 % CI 0.2, 1.2), P for trend = 0.003). For anxiety and insomnia, a stronger association was found in those with early T2D onset compared to late onset (per category change 1.3 % (95 % CI 0.9, 1.8) and 1.9 (95 % CI 1.3, 2.4), P for interaction = 0.001; 0.01). Conclusion The prevalence of pharmacologically treated depression, anxiety, and insomnia increased with diabetes duration; this finding may imply that assessment of mental health disorders at the initial phase and along the diabetes trajectory are needed. As the prevalences advanced most prominently in people with early onset T2D, future studies should determine underlying mechanisms to test age-appropriate preventive interventions.

• Tibelles, Hatuia Bø; Jenum, Anne Karen; Kirkebøen, Lars Johannessen; Berg, Tore Julsrud; Claudi, Tor & Cooper, John [Vis alle 10 forfattere av denne artikkelen] (2024). High prevalence of retinopathy in young-onset type 2 diabetes and possible sex differences: insights from Norwegian general practice. BMJ Open Diabetes Research & Care. 12(1). doi: 10.1136/bmjdrc-2023-003624. Fulltekst i vitenarkiv Vis sammendrag

  Introduction People with young-onset type 2 diabetes (YOD), defined as diabetes diagnosis before age 40, have a high lifetime risk of vascular complications. We aimed to estimate the prevalence of YOD among adults with type 2 diabetes (T2D) in Norwegian general practice and explore associations between age at diabetes diagnosis and retinopathy overall and in men and women. Research design and methods We collected cross-sectional data from general practice electronic medical records of 10 241 adults with T2D in 2014, and repeated measurements of hemoglobin A1c (HbA1c) from 2012 to 2014. Using multivariate logistic regression, we assessed associations between YOD and later-onset T2D, sex and retinopathy. Results Of all individuals with T2D, 10% were diagnosed before 40 years of age in both sexes. Compared with later-onset T2D, HbA1c increased faster in YOD, and at the time of diagnosis HbA1c was higher in men, particularly in YOD. Retinopathy was found in 25% with YOD, twice as frequently as in later onset. After adjustments for confounders (age, country of origin, education, body mass index), OR of retinopathy was increased in both men with YOD (OR 2.6 (95% CI 2.0 to 3.5)) and women with YOD (OR 2.2 (1.5 to 3.0)). After further adjustments for potential mediators (diabetes duration and HbA1c), the higher OR persisted in men with YOD (OR 1.8 (1.3 to 2.4)) but was attenuated and no longer significant for women with YOD. Conclusions Retinopathy prevalence was more than twice as high in YOD as in later-onset T2D. The increased likelihood of retinopathy in YOD was partly mediated by higher HbA1c and longer T2D duration, but after accounting for these factors it remained higher in men with YOD.

• Igland, Jannicke; Forster, Rachel Bedenis; Jenum, Anne Karen; Strandberg, Ragnhild Bjarkøy; Berg, Tore Julsrud & Røssberg, Jan Ivar [Vis alle 8 forfattere av denne artikkelen] (2024). How valid is a prescription-based multimorbidity index (Rx-risk) in predicting mortality in the Outcomes and Multimorbidity In Type 2 diabetes (OMIT) study? A nation-wide registry-based cohort study from Norway. BMJ Open. 14(3). doi: 10.1136/bmjopen-2023-077027. Fulltekst i vitenarkiv Vis sammendrag

  Objective: The prescription-based Rx-risk index has previously been developed to measure multimorbidity. We aimed to adapt and evaluate the validity of the Rx-risk index in prediction of mortality among persons with type 2 diabetes. Design: Registry-based study. Setting: Adults with type 2 diabetes in Norway identified within the ‘Outcomes and Multimorbidity In Type 2 diabetes’ cohort, with linkage to prescriptions from the Norwegian Prescription Database and mortality from the Population Registry. Participants: We defined a calibration sample of 42 290 adults diagnosed with type 2 diabetes 1950–2013, and a temporal validation sample of 7085 adults diagnosed 2014–2016 to evaluate the index validity over time Primary outcome measure: All-cause mortality Methods: For the calibration sample, dispensed drug prescriptions in 2013 were used to define 44 morbidity categories. Weights were estimated using regression coefficients from a Cox regression model with 5 year mortality as the outcome and all morbidity categories, age and sex included as covariates. The Rx-risk index was computed as a weighted sum of morbidities. The validity of the index was evaluated using C-statistic and calibration plots. Results: In the calibration sample, mean (SD) age at start of follow-up and duration of diabetes was 63.8 (12.4) and 10.1 (7.0) years, respectively. The overall C-statistic was 0.82 and varied from 0.74 to 0.85 when stratifying on age groups, sex, level of education and country of origin. In the validation sample, mean (SD) age and duration of diabetes was 59.7 (13.0) and 2.0 (0.8) years, respectively. Despite younger age, shorter duration of diabetes and later time period, the C-index was high both in the total sample (0.84) and separately for men (0.83) and women (0.84). Conclusions: The Rx-risk index showed good discrimination and calibration in predicting mortality and thus presents a valid tool to assess multimorbidity among persons with type 2 diabetes.

• Nøkleby, Kjersti; Jenum, Anne Karen; Buhl, Esben Selmer; Claudi, Tor; Cooper, John & Flottorp, Signe Agnes [Vis alle 9 forfattere av denne artikkelen] (2024). Effects on HbA1c of referral of type 2 diabetes patients to secondary care. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. s. 1–11. doi: 10.1080/02813432.2024.2433107. Fulltekst i vitenarkiv Vis sammendrag

  Aim: To study trajectories of HbA1c in type 2 diabetes (T2D) patients referred to diabetes outpatient clinics (DOCs), and to explore characteristics of referrals and patient pathways in patients treated in DOCs. Methods: We retrospectively followed T2D patients from the Norwegian population-based ROSA 4 study to identify persons with T2D who were referred to a DOC. We used latent class trajectory modelling to identify subgroups of patients with similar patterns of HbA1c one year before to one year after the first consultation at a DOC. We performed multinomial regression analyses to identify baseline characteristics associated with group membership. Results: Four hundred and two of 6716 T2D patients started treatment at a DOC, constituting a yearly starting rate of 1.5%. We identified three classes of HbA1c trajectories: (1) stable moderate hyperglycaemia (75%); (2) severe hyperglycaemia with a decline in HbA1c around referral (14%) and (3) severe hyperglycaemia with a decline in HbA1c after starting treatment at the DOC (11%). HbA1c trajectories were associated with diabetes duration RRR 0.92, CI (0.87, 0.97) in class 2 vs. 1 and 0.93 (0.88, 0.98) in class 3 vs. 1. Some differences were found between clinics in rejection rate, processes of care, and duration of follow-up. Conclusions: Norwegian GPs handle most T2D patients themselves. Those with T2D and severe hyperglycaemia had a considerable benefit from being referred to a DOC, though with two separate trajectories: One where HbA1c improved around the time of referral, and another that improved after starting in a DOC.

• Mdala, Ibrahimu; Nøkleby, Kjersti; Berg, Tore Julsrud; Cooper, John; Sandberg, Sverre & Løvaas, Karianne Fjeld [Vis alle 9 forfattere av denne artikkelen] (2023). Insulin initiation in patients with type 2 diabetes is often delayed, but access to a diabetes nurse may help—insights from Norwegian general practice. Scandinavian Journal of Primary Health Care. ISSN 0281-3432. 42(1). doi: 10.1080/02813432.2023.2296118. Fulltekst i vitenarkiv Vis sammendrag

  Objective: We opted to study how support staff operational capacity and diabetes competences may impact the timeliness of basal insulin-initiation in general practice patients with type 2 diabetes (T2D). Design/Setting/Outcomes: This was an observational and retrospective study on Norwegian primary care patients with T2D included from the ROSA4-dataset. Exposures were (1) support staff size, (2) staff size relative to number of GPs, (3) clinic access to a diabetes nurse and (4) share of staff with diabetes course (1 and 2 both relate to staff operational capacity, whereas 3 and 4 are both indicatory of staff diabetes competences). Outcomes were ‘timely basal insulin-initiation’ (primary) and ‘attainment of HbA1c<7%’ after insulin start-up (secondary). Associations were analyzed using multiple linear regression, and directed acyclic graphs guided statistical adjustments. Subjects: Insulin naïve patients with ‘timely’ (N = 294), ‘postponed’ (N = 219) or ‘no need of’ (N = 3,781) basal insulin-initiation, respectively. Results: HbA1c [median (IQR)] increased to 8.8% (IQR, 8.0, 10.2) prior to basal insulin-initiation, which reduced HbA1c to 7.3 (6.8–8.1) % by which only 35% of the subjects reached HbA1c <7%. Adjusted risk of ‘timely basal insulin-initiation’ was more than twofold higher if access to a diabetes nurse (OR = 2.40, [95%CI, 1.68, 3.43]), but related only vaguely to staff size (OR = 1.01, [95%CI, 1.00, 1.03]). No other staff factors related significantly to neither the primary nor the secondary outcome. Conclusion: In Norwegian general practice, insulin initiation in people with T2D may be affected by therapeutic inertia but access to a diabetes nurse may help facilitating more timely insulin start-up.

• Forster, Rachel Bedenis; Strandberg, Ragnhild Bjarkøy; Tibballs, Katrina Louise Bø; Nøkleby, Kjersti; Berg, Tore Julsrud & Iversen, Tor [Vis alle 15 forfattere av denne artikkelen] (2022). Cohort profile: Outcomes & Multi-morbidity In Type 2 diabetes (OMIT) - a national registry-based observational cohort with focus on care and treatment of key high-risk groups in Norway. BMJ Open. 12(5). doi: 10.1136/bmjopen-2021-054840. Fulltekst i vitenarkiv Vis sammendrag

  Purpose The ‘Outcomes & Multi-morbidity in Type 2 Diabetes’ (OMIT) is an observational registry-based cohort of Norwegian patients with type 2 diabetes (T2D) established to study high-risk groups often omitted from randomised clinical trials. Participants The OMIT cohort includes 57 572 patients with T2D identified via linkage of Norwegian Diabetes Register for Adults and the Rogaland-Oslo-Salten-Akershus-Hordaland study, both offering data on clinical patient characteristics and drug prescriptions. Subsequently these data are further linked to the Norwegian Prescription Database for dispensed medications, the Norwegian Population Register for data on death and migration, Statistics Norway for data on socioeconomic factors and ethnicity and the Norwegian Directorate of Health for data on the general practices and clinical procedures involved in the care of cohort patients. OMIT offers large samples for key high-risk patient groups: (1) young-onset diabetes (T2D at age <40 years) (n=6510), (2) elderly (age >75 years) (n=15 540), (3) non-Western ethnic minorities (n=9000) and (4) low socioeconomic status (n=20 500). Findings to date On average, patient age and diabetes duration is 67.4±13.2 and 12.3±8.3 years, respectively, and mean HbA1c for the whole cohort through the study period is 7.6%±1.5% (59.4±16.3 mmol/mol), mean body mass index (BMI) and blood pressure is 30.2±5.9 kg/m2 and 135±16.1/78±9.8 mm Hg, respectively. Prevalence of retinopathy, coronary heart disease and stroke is 10.1%, 21% and 6.7%, respectively. Future plans The OMIT cohort features 5784 subjects with T2D in 2006, a number that has grown to 57 527 in 2019 and is expected to grow further via repeated linkages performed every third to fifth year. At the next wave of data collection, additional linkages to Norwegian Patient Registry and Norwegian Cause of Death Registry for data on registered diagnoses and causes of death, respectively, will be performed.

• Strandberg, Ragnhild Bjarkøy; Nilsen, Roy Miodini; Pouwer, Frans; Igland, Jannicke; Forster, Rachel Bedenis & Jenum, Anne Karen [Vis alle 8 forfattere av denne artikkelen] (2022). Lower education and immigrant background are associated with lower participation in a diabetes education program - Insights from adult patients in the Outcomes & Multi-morbidity In Type 2 diabetes cohort (OMIT). Patient Education and Counseling. ISSN 0738-3991. 107, s. 1–7. doi: 10.1016/j.pec.2022.107577. Fulltekst i vitenarkiv Vis sammendrag

  Objectives Diabetes educational programmes should be offered to patients with type 2 diabetes mellitus (T2DM). We assessed the proportion of diabetes educational program participation among adults with T2DM, and its associations with place of residence in Norway, education, and immigrant background. Methods We identified 28,128 diagnosed with T2DM (2008–2019) in the Outcomes & Multi-morbidity In Type 2 diabetes cohort. To examine associations between sociodemographic factors and participation in diabetes start courses (yes/no), we computed adjusted risk ratios (95% CI) using log-binomial regression. Results Overall, 18% participated on the diabetes start course, but partaking differed by Norwegian counties (range:12–34%). Individuals with an immigrant background were 29% less likely to participate (RR 0.71, CI 0.65–0.79). Similarly, those with a lower educational level were 23% less likely to participate (RR 0.77, CI 0.72–0.83) than those with the highest education. The association between education and start course participation was not significant in the subgroup of immigrant individuals (RR 0.88 CI 0.70–1.12). Conclusions We found that diabetes start course participation was overall low, especially in individuals with low education and immigrant background.

• Slåtsve, Kristina Barbara; Claudi, Tor; Lappegård, Knut Tore; Jenum, Anne Karen; Larsen, Marthe & Nøkleby, Kjersti [Vis alle 12 forfattere av denne artikkelen] (2022). Level of education is associated with coronary heart disease and chronic kidney disease in individuals with type 2 diabetes: a population-based study. BMJ Open Diabetes Research & Care. 10(5). doi: 10.1136/bmjdrc-2022-002867. Fulltekst i vitenarkiv Vis sammendrag

  Introduction - To study the relationship between education level and vascular complications in individuals with type 2 diabetes in Norway.<p> <p>Research design and methods - Multiregional population-based cross-sectional study of individuals with type 2 diabetes in primary care. Data were extracted from electronic medical records in the period 2012–2014. Information on education level was obtained from Statistics Norway. Using multivariable multilevel regression analyses on imputed data we analyzed the association between education level and vascular complications. We adjusted for age, sex, HbA1c, low-density lipoprotein cholesterol, systolic blood pressure, smoking and diabetes duration. Results are presented as ORs and 95% CIs.<p> <p>Results - Of 8192 individuals with type 2 diabetes included, 34.0% had completed compulsory education, 49.0% upper secondary education and 16.9% higher education. The prevalence of vascular complications in the three education groups was: coronary heart disease 25.9%, 23.0% and 16.9%; stroke 9.6%, 7.4% and 6.6%; chronic kidney disease (estimated glomerular filtration rate <60 mL/min/1.73 m2) 23.9%, 16.8% and 12.6%; and retinopathy 13.9%, 11.5% and 11.7%, respectively. Higher education was associated with lower odds for coronary heart disease (OR 0.59; 95% CI 0.49 to 0.71) and chronic kidney disease (OR 0.75; 95% CI 0.60 to 0.93) compared with compulsory education when adjusting for age, sex, HbA1c, low-density lipoprotein cholesterol, systolic blood pressure, smoking and diabetes duration.<p> <p>Conclusions - In a country with equal access to healthcare, high education level was associated with lower odds for coronary heart disease and chronic kidney disease in individuals with type 2 diabetes.

• Nøkleby, Kjersti; Berg, Tore Julsrud; Mdala, Ibrahimu; Buhl, Esben Selmer; Claudi, Tor & Cooper, John [Vis alle 9 forfattere av denne artikkelen] (2021). High adherence to recommended diabetes follow-up procedures by general practitioners is associated with lower estimated cardiovascular risk. Diabetic Medicine. ISSN 0742-3071. 38(8), s. 1–11. doi: 10.1111/dme.14586. Fulltekst i vitenarkiv Vis sammendrag

  Aims To explore whether the general practitioners’ (GPs’) performance of recommended processes of care was associated with estimated risk of cardiovascular disease (CVD) and poor glycaemic control in patients with type 2 diabetes. Methods A cross-sectional study from Norwegian general practice including 6015 people with type 2 diabetes <75 years old, without CVD and their 275 GPs. The GPs were split into quintiles based on each GP’s average performance of six recommended processes of care. The quintiles were the exposure variable in multilevel regression models with 10-year risk of cardiovascular events estimated by NORRISK 2 (total and modifiable fraction) and poor glycaemic control (HbA1c >69 mmol/mol (>8.5%)) as outcome variables. Results The mean total and modifiable estimated 10-year CVD risk was 12.3% and 3.3%, respectively. Compared with patients of GPs in the highest-performing quintile, patients treated by GPs in the lowest quintile had an adjusted total and modifiable CVD risk that was 1.88 (95% CI 1.17–2.60) and 1.78 (1.14–2.41) percent point higher. This represents a relative mean difference of 16.6% higher total and 74.8% higher modifiable risk among patients of GPs in the lowest compared with the highest quintile. For patients with GPs in the lowest-performing quintile, the adjusted odds of poor glycaemic control was 1.77 (1.27–2.46) times higher than that for patients with a GP in the highest quintile. Conclusions We found a pattern of lower CVD risk and better glycaemic control in patients of GPs performing more recommended diabetes processes of care.

• Buhl, Christian Selmer; Stødkilde-Jørgensen, Hans; Videbech, Poul; Vaag, Allan; Møller, Niels & Lund, Sten [Vis alle 7 forfattere av denne artikkelen] (2018). Escitalopram ameliorates hypercortisolemia and insulin resistance in low birth weight men with limbic brain alterations. Journal of Clinical Endocrinology and Metabolism (JCEM). ISSN 0021-972X. 103(1), s. 115–124. doi: 10.1210/jc.2017-01438. Fulltekst i vitenarkiv

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• Strandberg, Ragnhild Bjarkøy; Nilsen, Roy Miodini; Pouwer, Francois; Igland, Jannicke; Røssberg, Jan Ivar & Jenum, Anne Karen [Vis alle 8 forfattere av denne artikkelen] (2025). Associations of diabetes duration with depression, anxiety and insomnia in people with type 2 diabetes mellitus. Fulltekst i vitenarkiv
• Strandberg, Ragnhild Bjarkøy; Nilsen, Roy Miodini; Pouwer, Francois; Igland, Jannicke; Røssberg, Jan Ivar & Jenum, Anne Karen [Vis alle 8 forfattere av denne artikkelen] (2024). Associations of diabetes duration with anxiety, depression, and insomnia in people with type 2 diabetes. Fulltekst i vitenarkiv
• Strandberg, Ragnhild Bjarkøy; Nilsen, Roy Miodini; Pouwer, Francois; Igland, Jannicke; Forster, Rachel Bedenis & Jenum, Anne Karen [Vis alle 8 forfattere av denne artikkelen] (2024). Associations of immigrant background and diabetes start course participation in individuals with type 2 diabetes in Norway – a study from the OMIT-cohort. Fulltekst i vitenarkiv
• Buhl, Esben Selmer; Igland, Jannicke; Forster, Rachel Bedenis; Jenum, Anne Karen; Strandberg, Ragnhild Bjarkøy & Berg, Tore Julsrud [Vis alle 8 forfattere av denne artikkelen] (2023). Prediction of mortality and validation of the ATC-code based Rx-risk comorbidity index in the “Outcomes & Multi-Morbidity In Type 2 diabetes” (OMIT) cohort. Fulltekst i vitenarkiv
• Tibballs, Katrina Louise Bø; Kirkebøen, Lars Johannessen; Jenum, Anne Karen; Straand, Jørund & Buhl, Esben Selmer (2023). EDUCATION LEVEL AND COUNTRY BACKGROUND IN YOUNG-ONSET TYPE 2 DIABETES. Fulltekst i vitenarkiv Vis sammendrag

  EDUCATION LEVEL AND COUNTRY BACKGROUND IN YOUNG-ONSET TYPE 2 DIABETES Background Type 2 diabetes (T2D) is associated with socioeconomic status and country background, but knowledge about the influence of these factors in young-onset T2D (YOD) is sparce. We aimed to examine the risk of YOD according to education level and country background. Methods Cross-sectional data from 2014 on 10241 individuals with T2D from Norwegian general practices (ROSA 4 study) were linked to data from Statistics Norway on country background and education level. Using separate data for the population of Norway, ROSA 4 individuals were compared with individuals matched for age, sex and residential area. Poisson regression analyses of T2D risk by country background and education compared YOD (diagnosis before age 40) with later onset T2D. Results In ROSA 4, 10% had YOD. Of these, 39% had non-Western background (22% South Asians) vs. 20% in the matched population. Among South Asians 29% of T2D was diagnosed before age 40 vs 7% of those with Norwegian background. Compulsory education was the highest education level in 36% in ROSA 4 vs 26% in the matched population. In YOD, these shares were 41% and 21%. T2D risk was increased in non-Western background compared to Norwegian background, particularly in South Asians (Incidence rate ratio, IRR 4.2 (4.0-4.5)). The risk was doubled in YOD (IRR 8.9 (8.0-9.8)). T2D risk was increased in individuals with lower education levels and the effect was larger in YOD (see table). There was an interaction between education level and country background in their association with YOD risk, individuals with Norwegian background, but not to South Asians, with low education having increased risk. Conclusion Non-Western background is associated with increased risk of T2D onset at a younger age. South Asians have particularly high risk. Low education is a risk factor for young-onset T2D in Norwegians, but not in South Asian immigrants.

• Tibballs, Katrina Louise Bø; Kirkebøen, Lars Johannessen; Jenum, Anne Karen; Straand, Jørund & Buhl, Esben Selmer (2023). Country background, education level, employment and disability in young-onset type 2 diabetes. Fulltekst i vitenarkiv Vis sammendrag

  Country background, education level, employment and disability in young-onset type 2 diabetes Background and Aims Young-onset type 2 diabetes (YOD – diagnosis before age 40) entails high disease burden and is mainly managed in general practice. Knowledge of how socioeconomic status and country background impact YOD risk is sparce. We aimed to study effects of education level and country background on YOD risk and effects of YOD on employment and disability. Materials and Methods Cross-sectional data on 10241 individuals with type 2 diabetes (T2D) from Norwegian general practices (ROSA 4 study, 2014), linked to data on country background, education level, disability benefits and employment, were compared with population data matched for age, sex and residential area. Using negative binomial regression and adjusting for age and sex, we analyzed YOD risk by country background and education level, and the effects of YOD on risk of disability and labour market absence. Results T2D risk was increased in non-Western compared to Norwegian background. South Asians exhibited the greatest risk increase, five-fold for T2D (adjusted incidence rate ratio, aIRR 4.7 (4.3-5.2)) and nine-fold for YOD (aIRR 8.9 (7.3-11.0)). T2D risk in low education was almost double that in high education, with YOD risk significantly higher than for later onset T2D (see table). There was significant interaction between low education and country background, with only Westerners exhibiting a substantially increased risk of YOD (aIRR 3.2 (2.4-4.4)). Disability risk was doubled in T2D (aIRR 2.2 (2.0-2.3) and three-fold higher in YOD (aIRR 3.1 (2.7-3.5) than in the population. Workforce participation was only reduced in T2D diagnosed before age 50. Conclusion Non-Western, particularly South Asian background and low education was associated with increased risk of YOD. Low education was an important YOD risk factor only for Westerners. Risk of disability and labour market absence was significantly higher in YOD than in later onset T2D and in the general population.

• Strandberg, Ragnhild Bjarkøy; Nilsen, Roy Miodini; Pouwer, Francois; Igland, Jannicke; Forster, Rachel Bedenis & Jenum, Anne Karen [Vis alle 8 forfattere av denne artikkelen] (2022). Participation in diabetes educational programs in adults with type 2 diabetes in Norway: whom are we reaching? Fulltekst i vitenarkiv
• Igland, Jannicke; Forster, Rachel Bedenis; Jenum, Anne Karen; Strandberg, Ragnhild Bjarkøy; Berg, Tore Julsrud & Røssberg, Jan Ivar [Vis alle 8 forfattere av denne artikkelen] (2022). The validity of the Rx-risk comorbidity index among adults in the Outcomes & Multimorbidity in Type 2 diabetes cohort (OMIT). Fulltekst i vitenarkiv
• Strandberg, Ragnhild Bjarkøy; Nilsen, Roy Miodini; Pouwer, Frans; Igland, Jannicke; Forster, Rachel Bedenis & Jenum, Anne Karen [Vis alle 8 forfattere av denne artikkelen] (2022). Associations of immigrant background and diabetes start course participation in adults with type 2 diabetes in Norway - a study from the OMIT-cohort. Fulltekst i vitenarkiv

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