Björn Eliasson

• MD, PhD
• Professor at University of Gothenburg

Objective To investigate standardized incidence of atrial fibrillation (AF) in individuals with type 1 diabetes (T1DMM) compared with matched controls from the general population. Additionally, to examine optimal levels- and relative importance of risk factors associated with AF and numbers of risk factors necessary to reduce excess risk in individ...

Background & Aims Disorders of gut‐brain interaction (DGBI) in obesity could impair health outcomes. Therefore, we aimed to study the prevalence and burden of symptoms compatible with a DGBI in obesity and assess the effect of obesity treatment on comorbid DGBI. Methods We used baseline and two‐year follow‐up data from a prospective non‐randomized...

Objectives The aim of this study was to investigate the risk of severe influenza resulting in hospitalisation among adults with type 1 diabetes (T1D). Design Nationwide cohort study using register data. Settings Data from the National Diabetes Register (NDR) linked to the Swedish Patient Register, Statistics Sweden and the Swedish Population Regi...

OBJECTIVE The widely adopted Kidney Disease: Improving Global Outcomes (KDIGO) classification system has been underused in assessing the burden and risk of adverse outcomes in type 1 diabetes. This observational study aimed to clarify how each KDIGO category correlates with outcomes, including mortality, in this patient group. RESEARCH DESIGN AND...

Aim: Intraindividual body weight variability (BWV), that is, the degree of weight fluctuations over time, is associated with an increased risk of cardiovascular diseases (CVDs) in multiple settings. The impact of BWV on cardiovascular risk in type 1 diabetes (T1D) remains unclear, despite the issues relative to weight management in individuals with...

Objective This study aimed to evaluate the effects of self‐reported baseline eating behaviors on 24‐month weight change in adults with severe obesity. Methods A prospective, nonrandomized clinical cohort study on surgical and medical obesity treatment included 971 adults (75% women) with a mean BMI of 42.0 (SD 4.9) kg/m ² . To assess baseline eati...

Importance Concerns have been raised regarding a link between use of glucagon-like peptide-1 (GLP-1) receptor agonists and increased risk of suicidality and self-harm. Objective To assess the association between use of GLP-1 receptor agonists and the risk of suicide death in routine clinical practice. Design, Setting, and Participants This active...

Using data from the Swedish National Diabetes Register, this study examines the gender disparity among patients with type 1 diabetes who have experienced a specific cardiovascular complication, while exploring the association between their weight variability, age group, and gender. Fourteen cardiovascular complications have been considered. This an...

Aims: To assess the comparative cardiovascular and renal effectiveness and safety of empagliflozin vs. dapagliflozin among patients with type 2 diabetes in routine clinical practice. Methods: Cohort study using data from nationwide registers in Sweden, Denmark and Norway, from June 2014 to June 2021 including 141 065 new users of empagliflozin a...

Background Obesity is highly overrepresented in individuals with psoriatic arthritis (PsA) and associated with increased disease activity and inferior treatment effect. We have earlier demonstrated in 39 patients with PsA and body mass index (BMI) ≥33 kg/m² that a 12-month (M12) weight loss regime was associated with significant improvements in C-r...

Background Obesity is over-represented in psoriatic arthritis (PsA) and associated with increased disease activity and poorer effect of treatment. A large body of evidence suggest that alterations in gut microbiota play a role in the development of metabolic syndrome. Deviations from the normal gut microbiome, dysbiosis, has also been demonstrated...

Background The aim of this study was to investigate temporal trends in survival and subsequent cardiovascular events in a nationwide myocardial infarction population with and without diabetes. Methods and Results Between 2006 and 2020, we identified 2527 individuals with type 1 diabetes, 48 321 individuals with type 2 diabetes and 243 170 individu...

Premature death in diabetes is increasingly caused by cancer. The objectives were to estimate the excess mortality when individuals with type 2 diabetes(T2D) were diagnosed with cancer, and to examine the impact of modifiable diabetes-related risk factors. This longitudinal nationwide cohort study included individuals with T2D registered in the Swe...

Continuous glucose monitoring (CGM) introduces novel indicators of glycemic control. This cross-sectional study, based on the Swedish National Diabetes Register, examines 27,980 adults with type 1 diabetes. It explores the relationships between HbA1c (glycated hemoglobin) and various CGM-derived metrics, including TIR (time in range, representing t...

Objective To investigate whether use of glucagon-like peptide 1 (GLP1) receptor agonists is associated with increased risk of thyroid cancer. Design Scandinavian cohort study. Setting Denmark, Norway, and Sweden, 2007-21. Participants Patients who started GLP1 receptor agonist treatment were compared with patients who started dipeptidyl peptidas...

Objective In this post hoc analysis of a previously published study, we compared cytokines and adipokine levels in women and men with psoriatic arthritis (PsA) at baseline (BL) and 6 months (M6) following a weight loss intervention. Methods Patients with PsA (n=41) between 25 and 75 years of age, with body mass index (BMI)≥33 kg/m ² were included...

Aims To develop and externally validate the LIFE‐T1D model for the estimation of lifetime and 10‐year risk of cardiovascular disease (CVD) in individuals with type 1 diabetes. Materials and Methods A sex‐specific competing risk‐adjusted Cox proportional hazards model was derived in individuals with type 1 diabetes without prior CVD from the Swedis...

Background Few studies have explored long-term trends and risk factors for peripheral arterial complications in type 2 diabetes compared to the general population. Our research focuses on identifying optimal risk factors, their significance, risk associated with multifactorial risk factor control, and trends for these complications in diabetic pati...

Background Observational studies on long-term trends, risk factor association and importance are scarce for type 1 diabetes mellitus and peripheral arterial outcomes. We set out to investigate trends in non-coronary complications and their relationships with cardiovascular risk factors in persons with type 1 diabetes mellitus compared to matched co...

Aims/hypothesis This register-based study aimed to describe autoimmune comorbidity in children and young adults from type 1 diabetes onset, and to investigate whether such comorbidity was associated with a difference in HbA1c or mortality risk compared with children/young adults with type 1 diabetes without autoimmune comorbidity. Methods A total...

Background and Aims Clinical trials suggest that glucagon-like peptide-1 (GLP-1) receptor agonists may have beneficial effects on NAFLD but the impact on hard hepatic endpoints is unknown. We assessed the association between use of GLP-1 receptor agonists and risk of serious liver events in routine clinical practice. Approach and Results Cohort st...

Introduction Patients with psoriatic arthritis (PsA) are frequently obese. We have previously shown decreased disease activity in patients with PsA with a body mass index (BMI) ≥ 33 kg/m² following weight loss treatment with Very Low Energy Diet (VLED), resulting in a median weight loss of 18.6% at six months (M6) after baseline (BL). In this study...

Aims: To investigate the association between glycemic control and outcome in people with type 2 diabetes (T2D) after carotid intervention due to carotid stenosis. Methods: Observational nationwide population-based cohort study using inverse probability treatment weighting (IPTW) and Cox regressions with covariates, that is, 4 stepwise models, in...

Aims: SMARTEST is a register-based randomized clinical trial (RRCT) that compares dapagliflozin to metformin in early-stage type 2 diabetes. The primary outcome includes progression of microvascular complications based on data from the Swedish National Diabetes Register (NDR). In this sub-study, the aim was to validate microvascular complication v...

Aims To develop and validate a recalibrated prediction model (SCORE2-Diabetes) to estimate the 10-year risk of cardiovascular disease (CVD) in individuals with type 2 diabetes in Europe. Methods and results SCORE2-Diabetes was developed by extending SCORE2 algorithms using individual-participant data from four large-scale datasets comprising 229 4...

Background: The goal of this work was to investigate trends (2001-2019) for cardiovascular events and cardiometabolic risk factor levels in individuals with type 2 diabetes (T2D) and matched control subjects. Methods: This study included 679 072 individuals with T2D from the Swedish National Diabetes Register and 2 643 800 matched control subjec...

Background: Cardiovascular risk factors control is fluctuating, tends to change over time, and is potentially impacted by multifactorial interactions. Currently, the existence of risk factors, rather than their variability or interplay with one another, is used to define the population at risk. The association between variability of risk factors a...

Background and aims: After bariatric surgery, micronutrient deficiencies may lead to anaemia. To prevent post-operative deficiencies, patients are recommended lifelong micronutrient supplementation. Studies investigating the effectiveness of supplementation to prevent anaemia after bariatric surgery are scarce. This study aimed to investigate the...

Background Type 2 diabetes mellitus (T2DM) is considered a risk factor for fracture but the evidence regarding the impact of T2DM on fracture risk is conflicting. The objective of the study was to determine if patients with T2DM have increased fracture risk and if T2DM-related risk factors could be identified. Methods and findings In this national...

During the last few years SGLT2 inhibitors have quickly become an important alternative in treating type 2 diabetes, heart failure and chronic kidney disease. The hallmark studies that resulted in inclusion of SGLT2 inhibitors in international treatment guidelines for these diseases excluded individuals with recent acute illness and thus the eviden...

Aims: To assess treatment eligibility for, and received treatment with, sodium-glucose co-transporter 2 inhibitors (SGLT2) and glucagon-like peptide-1 (GLP-1) receptor agonists according to the 2019 ADA/EASD consensus report and the 2019 ESC guidelines in a nationwide sample of patients with type 2 diabetes. Methods and results: Both sets of gui...

Aims: The 2021 European Society of Cardiology (ESC) guidelines recommend that patients with type 2 diabetes (T2D) with a very high cardiovascular disease (CVD) risk receive cardiovascular (CV)-protective glucose-lowering medication (glucagon-like peptide-1 receptor agonists or sodium-glucose co-transporter-2 inhibitors). This analysis compared pre...

OBJECTIVE To assess the association between use of sodium–glucose cotransporter 2 (SGLT2) inhibitors and the risk of new-onset atrial fibrillation (AF) in routine clinical practice. RESEARCH DESIGN AND METHODS We used nationwide registers in Denmark, Norway, and Sweden from 2013 to 2018 in order to include patients without a history of AF who were...

Background and objectives Individuals with type 2 diabetes are at a higher risk of developing kidney failure. The objective of this study was to develop and validate a decision support tool for estimating 10-year and lifetime risks of kidney failure in individuals with type 2 diabetes as well as estimating individual treatment effects of preventive...

OBJECTIVE Patients with diabetes or familial hypercholesterolemia (FH) have an increased incidence of cardiovascular diseases compared with the population, but whether this risk is exacerbated in patients with combined traits is unknown. RESEARCH DESIGN AND METHODS In this Swedish nationwide, register-based cohort study, patients with diabetes wer...

People with type 1 diabetes have a substantially increased risk of premature death. This nationwide, register-based cohort study evaluated the significance of risk factors and previous cardiovascular disease (CVD), heart failure and chronic kidney disease (CKD), for mortality in type 1 diabetes. Nationwide, longitudinal, register-based cohort study...

Context Obesity is considered to have a detrimental impact on health-related quality of life (HRQoL). Objective To compare HRQoL in a well-defined group of people with obesity with a population-based control group from the general public. Design Observational cross-sectional cohort study with a reference population. Setting The Regional Obesity...

Aims/hypothesis The association between type 2 diabetes (T2D) and the development of cardiac arrhythmias and conduction disturbances has not been extensively studied. Methods Arrhythmia was defined as atrial fibrillation and flutter (AF/AFl), ventricular tachycardia (VT) and ventricular fibrillation (VF), and conduction abnormality as sinus node di...

This narrative review describes a new approach to navigation in a challenging landscape of clinical drug development in diabetes. Successful outcome studies in recent years have led to new indications and guidelines in type 2 diabetes, yet the number of clinical trials in diabetes is now declining. This is due to many environmental factors acting i...

Objective: To explore oral health by increasing degree of obesity and the influence of modifying factors. Materials and methods: A cross-sectional design was used. Swedish females (n = 118; 18-35 years) with morbid obesity were recruited from the BAriatric SUbstitution and Nutrition study (BASUN). Body mass index (BMI) was used as continuous and...

Although the increased risk of complications of type 2 diabetes (T2D) is well known, there is still little information about the long-term development of comorbidities in relation to risk factors. The purpose of the present study was to describe the risk trajectories of T2D complications over time in an observational cohort of newly diagnosed T2D p...

Background: The role of diabetes in the development of valvular heart disease and particularly the relation with risk factor control, has not been extensively studied. Methods: We included 715,143 patients with diabetes registered in the Swedish National Diabetes Register and compared them with 2,732,333 matched controls randomly selected from the...

Objectives: To evaluate the effects of weight loss treatment on physical fitness in patients with psoriatic arthritis (PsA) and obesity compared to matched controls. Methods: In total, 46 patients with PsA (CASPAR) and BMI ≥ 33 kg/m2 and 52 obese persons were included in this 12-month prospective open intervention study with a very low energy di...

Background Obesity is over-represented in patients with psoriatic arthritis (PsA) and associated with increased disease activity. We have previously shown that weight loss treatment with Very Low Energy Diet (VLED) in patients with PsA and obesity was associated with a sustained weight reduction and significant improvement of the disease activity i...

Objectives To compare long-term effects and complications of medical treatment (MT) of obesity including very low energy diet with bariatric surgery. Design and setting This prospective study conducted in a clinical setting recruited individuals with body mass index (BMI) ≥35 kg/m ² referred for obesity treatment. Demographic and anthropometric da...

Background Sustainable dietary, behavioural and lifestyle changes are necessary to accomplish weight loss. Aim Evaluate impact of internal motivation, locus of control and self-efficacy on non-surgical weight loss treatment in patients with severe obesity. Methods A total of 1196 patients, Body Mass Index ≥35 kg/m², referred to obesity treatment...

Background HbA1c variability has emerged as risk factor for cardiovascular diseases in diabetes. However, the impact of HbA1c variability on cardiovascular diseases in subjects within the recommended HbA1c target has been relatively unexplored. Methods Using data from a large database, we studied 101,533 people with type 2 diabetes without cardiov...

Objective: To compare the validity and robustness of five methods for handling missing characteristics when using cardiovascular disease risk prediction models for individual patients in a real-world clinical setting. Study design and setting: The performance of the missing data methods was assessed using data from the Swedish NDR (n=419,533) with...

Aims: To assess the comparative cardiovascular and renal effectiveness of SGLT2 inhibitors vs GLP-1-receptor-agonists in routine clinical practice. Materials and methods: Cohort study of nationwide registers from Sweden, Denmark and Norway, 2013-2018, including 87525 new users of SGLT2 inhibitors and 63921 new users of GLP-1-receptor-agonists, a...

Objective: To investigate the nature of the relationship between HbA1c and sepsis among individuals with type 2 diabetes, and to assess the association between sepsis and all-cause mortality in such patients. Research design and methods: We included 502,871 individuals with type 2 diabetes recorded in the Swedish National Diabetes Register and u...

Type 1 diabetes is a chronic autoimmune disease requiring insulin treatment for survival. Prolonged duration of type 1 diabetes is associated with increased risk of microvascular complications. Although chronic hyperglycemia and diabetes duration have been considered as the major risk factors for vascular complications, this is not universally seen...

Background and aims Insulin resistance contributes to the development of type 2 diabetes (T2D) and is also a cardiovascular risk factor. The aim of this study was to investigate the potential association between insulin resistance measured by estimated glucose disposal rate (eGDR) and risk of stroke and mortality thereof in people with T2D. Materi...

Aims/hypothesis Concerns have been raised regarding a potential association of use of the incretin-based drugs dipeptidyl peptidase 4 (DPP4) inhibitors and glucagon-like peptide-1 (GLP-1)-receptor agonists with risk of cholangiocarcinoma. We examined this association in nationwide data from three countries. Methods We used data from nationwide reg...

Aims/hypothesis Tables reporting life expectancies by common risk factors are available for individuals with type 2 diabetes; however, there is currently no published equivalent for individuals with type 1 diabetes. We aimed to develop a life expectancy table using a recently published simulation model for individuals with type 1 diabetes. Methods...

Background The development of obesity is most likely due to a combination of biological and environmental factors some of which might still be unidentified. We used a machine learning technique to examine the relative importance of more than 100 clinical variables as predictors for BMI. Methods BASUN is a prospective non-randomized cohort study of...

Aims/hypothesis Research using data-driven cluster analysis has proposed five novel subgroups of diabetes based on six measured variables in individuals with newly diagnosed diabetes. Our aim was (1) to validate the existence of differing clusters within type 2 diabetes, and (2) to compare the cluster method with an alternative strategy based on tr...

Background There is a high incidence of cardiovascular disease in diabetes. Weight variability has been reported as independent risk factor for cardiovascular disease in the general population and preliminarily also in people with type 2 diabetes. Methods Using data from the Swedish National Diabetes Register the possible link between visit-to-vis...

The study of metabolomics has improved our knowledge of the biology behind type 2 diabetes and its related metabolic physiology. We aimed to investigate markers of adipose tissue morphology, as well as insulin and glucose metabolism in 53 non-obese male individuals. The participants underwent extensive clinical, biochemical and magnetic resonance i...

The interactive life expectancy table is available at https://antranduy.shinyapps.io/le-t1d/

Introduction: Lipid-lowering therapy (LLT) reduces the risk of cardiovascular disease (CVD) in patients with type 1 diabetes (T1D). However, socioeconomic factors and gender may have an impact on the adherence to and non-persistence with LLT. Methods: This was a nationwide register-based cohort study that included 6192 individuals with T1D aged...

Aim SGLT2 inhibitors have been shown to reduce cardiovascular and renal complications in type 2 diabetes (T2D) patients at high cardiovascular risk. Metformin is currently widely used as initial monotherapy in T2D but lacks convincing data to show that it reduces risk of complications. We aim to compare the SGLT2 inhibitor dapagliflozin and metform...

Objective Wounds such as lower extremity ulcers are serious, costly and frequently hard to heal. Guidelines conclude that new dressings and treatments generally fail to show superiority compared with standard of care. Several mechanisms are probably responsible for impaired healing of hard-to-heal wounds, including inflammation and infection. Amino...

Background Obesity is highly overrepresented in psoriatic arthritis (PsA) and associated with increased disease activity. We have previously shown in 41 patients with PsA (Caspar criteria) and obesity (here body mass index BMI ≥33 kg/m²) that weight loss treatment including Very Low Energy Liquid Diet (VLED) resulted in a median weight loss of 18.6...

The risk of major amputation is higher after urgently planned endovascular therapy for chronic limb-threatening ischemia (CLTI) in patients with diabetes mellitus (DM). The aim of this nationwide cohort study was to compare outcomes between patients with and without DM following urgently planned open revascularization for CLTI from 2010 to 2014. Ou...

Background: Whether infection with SARS-CoV-2 leads to excess risk of requiring hospitalization or intensive care in persons with diabetes has not been reported, nor have risk factors in diabetes associated with increased risk for these outcomes. Methods: We included 44,639 and 411,976 adult patients with type 1 and type 2 diabetes alive on Jan 1,...

Background: Whether infection with SARS-CoV-2 leads to excess risk of requiring hospitalization or intensive care in persons with diabetes has not been reported, nor have risk factors in diabetes associated with increased risk for these outcomes. Methods: We included 44,639 and 411,976 adult patients with type 1 and type 2 diabetes alive on Jan...

Objectives To investigate early and long-term outcomes after treatment of carotid artery stenosis in patients with type 2 diabetes (T2D) compared to patients without T2D. Design/method This observational nationwide population-based retrospective cohort study investigated all T2D patients treated for carotid stenosis registered in the National Swed...

Background The study of metabolomics has improved our knowledge of the biology behind type 2 diabetes and its related metabolic dysregulations. We aimed to investigate markers of adipose tissue morphology dysfunction and insulin and glucose metabolism dysfunction in 53 non-obese male individuals. Methods The participants underwent extensive clinica...

Introduction Evidence on the effects of structured nutrition education is weak in adults with type 1 diabetes mellitus (T1D) with moderately impaired glycemic control. Objective was to compare the effects of different types of nutrition education programs on glycemic control, cardiovascular risk factors, quality of life, diet quality and food choic...

Background Obesity and diabetes mellitus are strongly associated with heart failure (HF) and atrial fibrillation (AF). The benefits of bariatric surgery on cardiovascular outcomes are known in people with or without diabetes mellitus. Surgical treatment of obesity might also reduce the incidence of HF and AF in individuals with obesity and type 2 d...

Background Major prospective randomized clinical safety trials have demonstrated beneficial effects of treatment with glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium–glucose co-transporter-2 inhibitors (SGLT-2i) in people with type 2 diabetes and elevated cardiovascular risk, and recent clinical treatment guidelines therefore promote...

Objectives To investigate early and long-term outcomes after treatment of carotid artery stenosis in patients with type 2 diabetes (T2D) compared to patients without T2D.Design/Method This observational nationwide population-based cohort study investigated all T2D patients treated for carotid stenosis registered in the National Swedish Vascular Sur...

Importance Knowledge of the incidence and progression of diabetic retinopathy (DR) after gastric bypass surgery (GBP) in patients with obesity and diabetes could guide the management of these patients. Objective To investigate the incidence of diabetic ocular complications in patients with type 2 diabetes after GBP compared with the incidence of d...

Background: Diabetes mellitus (DM) is a risk factor for peripheral arterial disease (PAD). Indications for open surgery in infrainguinal intermittent claudication (IC) are limited, and reports are lacking regarding outcomes in DM patients. Study aims were to compare short and long-term effects on major adverse cardiovascular events (MACE), acute my...

Aim: - To compare treatment persistence in patients with type 2 diabetes mellitus initiating the glucagon-like peptide-1 receptor agonists (GLP-1 RAs) dulaglutide, exenatide once-weekly (QW), liraglutide, or lixisenatide in routine clinical practice in Sweden and assess clinical outcomes. Materials and methods: We performed a retrospective study...

Randomized controlled trial (RCT) populations often do not reflect those typically seen in clinical practice. This retrospective, observational cohort study analysed real‐world data of people with type 2 diabetes (T2DM) prescribed basal insulin analogues from electronic medical records (EMRs) in the Explorys database, which includes data from 39 in...

2020 will go down in history as the year when the global community was awakened to the fragility of human health and the interdependence of the ecosystem, economy, and humanity. Amid the COVID-19 pandemic, the vulnerability of people with diabetes during a public health emergency became evident by their at least 2 times increased risk of severe dis...

Background/Introduction Obstructive sleep apnoe (OSA) and type 2 diabetes (T2D) occurs more frequently in persons with obesity, and both OSA and T2D are associated with metabolic disturbances that increases the risk for cardiovascular disease (CVD). In EMPA-REG OUTCOME, a randomized placebo-controlled outcome trial involving 7020 patients with T2D...

Type 1 diabetes (T1D) is largely considered an autoimmune disease leading to the destruction of insulin-producing pancreatic β cells. Further, patients with T1D have 3–4-fold increased risk of developing micro- and macrovascular complications. However, the contribution of immune-related factors contributing to these diabetes complications are poorl...

Background: Obesity is overrepresented in patients with psoriatic arthritis (PsA) and associated with increased disease activity. We have previously shown in 41 patients with PsA (Caspar criteria) and obesity (body mass index; BMI ≥33 kg/m2) that weight loss treatment with Very Low Energy Liquid Diet (VLED), 640 kcal/day during 12-16 weeks, follow...

Background Diabetes mellitus (DM) is an established risk factor for intermittent claudication (IC) and other manifestations of atherosclerotic peripheral arterial disease. Indications for surgery in infrainguinal IC are debated, and there are conflicting reports regarding its outcomes in patients with DM. Aims of this study were to compare both sho...

Objective: To study the potential long-term benefits and possible complications of bariatric surgery in patients with type 1 diabetes (T1D). Research design and methods: In this register-based nationwide cohort study, we compared individuals with T1D and obesity who underwent Roux-en-Y gastric bypass (RYGB) surgery with patients with T1D and obe...