Katrina Louise Bø Tibballs

• 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
• 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.

• 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.

• 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.

• Tibballs, Katrina Louise Bø; Ambur, Ole Herman; Alfsnes, Kristian; Homberset, Håvard; Frye, Stephan Alfons & Davidsen, Tonje [Vis alle 7 forfattere av denne artikkelen] (2009). Characterization of the meningococcal DNA glycosylase Fpg involved in base excision repair. BMC Microbiology. 9. doi: 10.1186/1471-2180-9-7. Fulltekst i vitenarkiv Vis sammendrag

  Background Neisseria meningitidis, the causative agent of meningococcal disease, is exposed to high levels of reactive oxygen species inside its exclusive human host. The DNA glycosylase Fpg of the base excision repair pathway (BER) is a central player in the correction of oxidative DNA damage. This study aimed at characterizing the meningococcal Fpg and its role in DNA repair. Results The deduced N. meningitidis Fpg amino acid sequence was highly homologous to other Fpg orthologues, with particularly high conservation of functional domains. As for most N. meningitidis DNA repair genes, the fpg gene contained a DNA uptake sequence mediating efficient transformation of DNA. The recombinant N. meningitidis Fpg protein was over-expressed, purified to homogeneity and assessed for enzymatic activity. N. meningitidis Fpg was found to remove 2,6-diamino-4-hydroxy-5-formamidopyrimidine (faPy) lesions and 7,8-dihydro-8-oxo-2'-deoxyguanosine (8oxoG) opposite of C, T and G and to a lesser extent opposite of A. Moreover, the N. meningitidis fpg single mutant was only slightly affected in terms of an increase in the frequency of phase variation as compared to a mismatch repair mutant. Conclusion Collectively, these findings show that meningococcal Fpg functions are similar to those of prototype Fpg orthologues in other bacterial species.

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• 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.

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