Reimar W Thomsen

• MD, PhD
• Professor (Associate) at Aarhus University

Objective To evaluate whether atherosclerotic cardiovascular disease outcomes, venous thromboembolism, heart failure, and cardiovascular mortality are elevated in patients with primary Sjögren’s syndrome (pSS) compared with a matched cohort from the general population. Methods We conducted a nationwide population-based cohort study including all p...

Glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) have emerged as key agents for weight management, based on their marked efficacy as observed in randomized controlled trials. While still limited, real‐world studies on GLP‐1RA use in populations with obesity are increasingly available. This narrative review discusses contemporary real‐world evid...

Background We examined the association of serum YKL-40, an inflammatory biomarker, with incident cancer risk in early type 2 diabetes. Methods A cohort of 11,346 individuals newly diagnosed with type 2 diabetes was followed for up to 14 years. YKL-40 levels (n = 9010) were categorised into five percentiles (0–33%, 34–66%, 67–90%, 91–95%, and 96–10...

Novel therapies are emerging for the prevention of chronic kidney disease (CKD) progression in patients with type 2 diabetes (T2D). Within the FOUNTAIN platform (NCT05526157; EUPAS48148), this real-world study aimed to characterize cohorts of adults with CKD and T2D starting therapy with a glucagon-like peptide-1 receptor agonist (GLP-1 RA) in Euro...

Aims Since the launch of semaglutide for weight loss (Wegovy®, SEMA‐WL) in late 2022, there has been a huge increase in new users of SEMA‐WL. We explored characteristics, treatment expectations and experienced effectiveness and side effects among Danish adults using SEMA‐WL. Materials and Methods A questionnaire‐based survey was conducted from Sep...

Aims/hypothesis Low birthweight (LBW) is associated with younger age, less obesity and more hypertension among people recently diagnosed with type 2 diabetes, as well as increased cardiovascular morbidity and mortality risk. It is not known whether LBW is associated with an increased risk of incident chronic kidney disease (CKD) among people with a...

Importance No large randomized clinical trial has directly compared empagliflozin with dapagliflozin, leaving their comparative effectiveness regarding kidney outcomes unknown. Objective To compare kidney outcomes between initiation of empagliflozin vs dapagliflozin in adults with type 2 diabetes who were receiving antihyperglycemic treatment. De...

Aims TCF7L2 rs7903146 is the most impactful single genetic risk variant for type 2 diabetes. However, its role on disease progression, complications and mortality among people with type 2 diabetes at diagnosis remains unclear. Materials and Methods We assessed the per allele impact of the rs7903146 T‐allele on clinical characteristics and complica...

Background: Stroke is a major cause of death globally, especially in type 2 diabetes (T2D) patients. Fibrinogen is known to predict stroke risk, but fibrinogen is a highly variable protein and we hypothesized that fibrinogen variants can improve stroke prediction. Objectives: To investigate the association of total fibrinogen and fibrinogen variant...

The clinical landscape for the treatment of patients with chronic kidney disease (CKD) and type 2 diabetes (T2D) is rapidly evolving. As part of the FOUNTAIN platform (NCT05526157; EUPAS48148), we described and compared cohorts of adult patients with CKD and T2D initiating a sodium-glucose cotransporter 2 inhibitor (SGLT2i) before the launch of fin...

Aims/hypothesis A better understanding of the mechanisms underlying an elevated infection risk in individuals with type 2 diabetes is needed to guide risk stratification and prevention. We investigated the risk of infection in subgroups of individuals with type 2 diabetes according to indices of insulin sensitivity and beta cell function. Methods...

OBJECTIVE To examine trends in peripheral artery disease (PAD), lower-extremity (LE) revascularization, and LE amputation in patients with incident type 2 diabetes. RESEARCH DESIGN AND METHODS This cohort study included patients in Denmark diagnosed with type 2 diabetes in 1996–2015 and followed until 2020. Patients were age and sex matched with a...

Purpose Data on type 2 diabetes (T2D) risk after breast cancer (BC) could guide preventive strategies. Yet, studies had limitations regarding sample size, follow-up, and contemporary treatments. We evaluated the risk of T2D after BC overall, by cancer treatment, and compared with a matched cohort of cancer-free women. Methods We assembled a popula...

Purpose This paper provides an overview of the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort and biobank, including baseline characteristics of participants enrolled up to 2023, and post-enrollment rates of cardiovascular disease outcomes and mortality. Methods Since 2010, the DD2 project has enrolled individuals with type 2...

Aim To analyse patterns of glucose‐lowering therapies among people with type 2 diabetes (T2D) in Denmark from 2016 to 2023. Materials and Methods We examined time trends in the clinical profiles of people with T2D who initiated different glucose‐lowering therapy classes for the first time. We furthermore investigated individual‐level treatment tra...

BACKGROUND Empagliflozin and dapagliflozin have proven cardiovascular benefits in people with type 2 diabetes at high cardiovascular risk, but their comparative effectiveness is unknown. METHODS This study used nationwide, population-based Danish health registries to emulate a hypothetical target trial comparing empagliflozin versus dapagliflozin...

Introduction & Objective: Low birthweight (BW), a proxy for an adverse intrauterine environment, has been associated with risk of type 2 diabetes (T2D) and chronic kidney disease (CKD) later in life. The extent to which lower birthweight among people with T2D increases risk of CKD is unknown. Methods: Original midwife records were reviewed for 5979...

Background and objectives: Reduction of blood lipids may aid in preventing diabetic polyneuropathy (DPN), but evidence remains conflicting. We investigated the association between lipid parameters and DPN risk in individuals with type 2 diabetes mellitus (T2DM). Methods: We conducted a population-based cohort study of individuals with newly diag...

Aim Diabetes is associated with increased risk of dementia, but it is still debated to which degree this risk depends on the presence of atherosclerotic cardiovascular disease. We hypothesized that patients with diabetes and co-existing coronary artery disease (CAD), as a marker of systemic atherosclerotic cardiovascular disease, have substantially...

Purpose A surge in the use of semaglutide injection (Ozempic®) approved to treat type 2 diabetes (T2D) has led to a global supply shortage. We investigated contemporary user rates and clinical characteristics of semaglutide (Ozempic®) users in Denmark, and the extent of “off-label” prescribing for weight loss. Patients and Methods Nationwide popul...

Type 2 diabetes is a heterogeneous disease that can be subdivided on the basis of β-cell function and insulin sensitivity. We investigated the presence, incidence, and progression of diabetic retinopathy (DR) according to subtypes of type 2 diabetes. In a national cohort, we identified three subtypes of type 2 diabetes: classical, hyperinsulinemic,...

Aims To determine the magnitude of the association between abdominal adiposity and low‐grade inflammation in persons with recently diagnosed type 2 diabetes (T2D) and to determine to what extent this association is mediated by low physical activity level, hyperinsulinaemia, hyperglycaemia, dyslipidaemia, hypertension, and comorbidities. Materials...

Background Chronic kidney disease (CKD) is a growing global health concern. Identifying individuals in routine clinical care with new-onset CKD at high risk of rapid progression of the disease is imperative to guide allocation of prophylactic interventions, but community-based data are limited. We aimed to examine the risk of rapid progression, kid...

Purpose Examine preadmission diagnoses, medication use, and preadmission healthcare utilization among older adults prior to first potentially avoidable hospitalizations. Methods A nationwide population-based case–control study using Danish healthcare data. All Danish adults aged ≥ 65 years who had a first potentially avoidable hospitalization from...

Objective: To determine the association of hospital-diagnosed morbidity and recent surgery with risk of subsequent Guillain-Barré syndrome (GBS) development. Methods: We conducted a nationwide population-based case-control study of all patients with first-time hospital-diagnosed GBS in Denmark between 2004 and 2016 and ten age, sex and index dat...

Aims/hypothesis Low birthweight is a risk factor for type 2 diabetes but it is unknown whether low birthweight is associated with distinct clinical characteristics at disease onset. We examined whether a lower or higher birthweight in type 2 diabetes is associated with clinically relevant characteristics at disease onset. Methods Midwife records w...

Tuberculosis (TB) is a risk factor for chronic obstructive pulmonary disease (COPD), but COPD is also a predictor of TB. The excess life-years lost to COPD caused by TB can potentially be saved by screening for and treating TB infection. The purpose of this study was to examine the number of life-years that could be saved by preventing TB and TB-at...

Introduction Habitual physical activity behaviors of individuals with new-onset type 2 diabetes are largely unknown. We aimed to investigate accelerometer-derived physical activity behaviors in individuals with newly diagnosed type 2 diabetes. We also examined sociodemographic and health-related correlates of a high-risk physical activity profile....

Aims Rare variants in the glucokinase gene (GCK) cause Maturity-Onset Diabetes of the Young (MODY2/GCK-MODY). We investigated the prevalence of GCK variants, phenotypic characteristics, micro- and macrovascular disease at baseline and follow-up, and treatment among individuals with and without pathogenic GCK variants. Methods This is a cross-secti...

Introduction: The aim of this study was to validate type 1 diabetes in women giving live birth in the Danish national registries against a clinical cohort of confirmed cases (the Danish Diabetes Birth Registry [DDBR] cohort). Methods: National registries including diagnosis codes, redeemed prescriptions and background data were combined. Three m...

Introduction: The sodium-glucose cotransporter 2 inhibitor (SGLT2i) empagliflozin has shown reductions in major adverse cardiac events similar to glucagon-like peptide-1 receptor agonists (GLP-1RAs). However, evidence is limited about how these therapies compare regarding overall healthcare resource utilization and costs in routine clinical care....

Introduction Pre-diabetes increases the risk of type 2 diabetes, but data are sparse on predictors in a population-based clinical setting. We aimed to develop and validate prediction models for 5-year risks of progressing to type 2 diabetes among individuals with incident HbA1c-defined pre-diabetes. Research design and methods In this population-b...

OBJECTIVE We examined temporal trends in risk of first-time ischemic stroke in patients with incident type 2 diabetes mellitus (T2DM) and no prior atherosclerotic cardiovascular disease (ASCVD). RESEARCH DESIGN AND METHODS Using nationwide health registries, we identified all patients with incident T2DM without a prior hospital diagnosis of ASCVD...

Introduction A Swedish data-driven cluster study identified four distinct type 2 diabetes (T2D) clusters, based on age at diagnosis, body mass index (BMI), hemoglobin A1c (HbA1c) level, and homeostatic model assessment 2 (HOMA2) estimates of insulin resistance and beta-cell function. A Danish study proposed three T2D phenotypes (insulinopenic, hype...

Background In 2011, the World Health Organization began recommending glycated haemoglobin (HbA1c) as a measure for diagnosing type 2 diabetes (T2D). This initiative may have changed basic T2D epidemiology. Consequently, we examined time changes in T2D incidence and mortality during 1995-2018. Methods In this population-based cohort study, we inclu...

Purpose/background: Data on the effect of treatment with antidepressant drugs on metabolic control in diabetes are sparse. In this controlled within-subject before-after study, the impact of initiation and discontinuation of antidepressant treatment on hemoglobin A1c (HbA1c) and low-density lipoprotein (LDL) levels in type 2 diabetes was estimated...

Objective To investigate the association between SARS-CoV-2 vaccination and myocarditis or myopericarditis. Design Population based cohort study. Setting Denmark. Participants 4 931 775 individuals aged 12 years or older, followed from 1 October 2020 to 5 October 2021. Main outcome measures The primary outcome, myocarditis or myopericarditis, w...

Importance Influenza has been associated with the risk of developing Parkinson disease, but the association is controversial. Objective To examine whether prior influenza and other infections are associated with Parkinson disease more than 10 years after infection. Design, Setting, and Participants This case-control study used data from 1977 to 2...

The impact of different types of mental disorders on long‐term glycemic and lipid trajectories following newly diagnosed type 2 diabetes (T2D) remains unknown. We used real‐world clinical data in a population‐based cohort to fill this knowledge gap. We found that individuals with new T2D and preexisting personality, anxiety, unipolar depression, or...

Objective: Trends in cardiac risk and death have not been examined in patients with incident type 2 diabetes and no prior cardiovascular disease. Therefore, we aimed to examine trends in cardiac risk and death in relation to the use of prophylactic cardiovascular medications in patients with incident type 2 diabetes without prior cardiovascular di...

Objective: Symptoms indicative of diabetic polyneuropathy (DPN) early in type 2 diabetes may act as a marker for cardiovascular disease (CVD) and death. Research design and methods: We linked data from two Danish type 2 diabetes cohorts, the Anglo-Danish-Dutch Study of Intensive Treatment in People With Screen-Detected Diabetes in Primary Care (...

Background In cardiovascular outcome trials, the sodium glucose cotransporter 2 inhibitor empagliflozin and glucagon‐like peptide‐1 (GLP‐1) receptor agonist liraglutide caused similar reductions in major adverse cardiac events (MACE). We compared clinical outcomes in routine clinical care. Methods and Results EMPLACE (Cardiovascular and Renal Outc...

Aims: Patients with diabetes and no obstructive coronary artery disease (CAD) as assessed by coronary angiography (CAG) are frequently treated with aspirin and statins. We examined the effectiveness of aspirin and statin treatment on cardiovascular and bleeding incidence in patients with diabetes and absent obstructive CAD. Methods and results:...

Objective: To examine the association between body mass index (BMI) and mortality after hospitalization for infection because obesity is associated with increased energy reserves that may protect against death from severe infections. Patients and methods: Of 76,044 patients admitted with a primary infection diagnosis from January 1, 2011, to Sep...

Aims/hypothesis We aimed to assess whether current antidepressant therapy or a history of hospital-diagnosed depression affects diabetes treatment initiation, adherence, and HbA1c and LDL-cholesterol target achievement. Methods In this register-based study, we included all individuals from Central and Northern Denmark with newly diagnosed type 2 d...

Importance: Alpha 1-adrenergic receptor blocking agents (α1-blockers) have been reported to have protective benefits against hyperinflammation and cytokine storm syndrome, conditions that are associated with mortality in patients with coronavirus disease 2019 and other severe respiratory tract infections. However, studies of the association of α1-...

Objective: End-stage kidney disease (ESKD) is a life-threatening complication of diabetes that can be prevented or delayed by intervention. Hence, early detection of people at increased risk is essential. Research design and methods: From a population-based cohort of 5,460 clinically diagnosed Danish adults with type 1 diabetes followed from 200...

Objective To determine whether hospital-diagnosed and community-treated infections are important Guillain-Barré syndrome (GBS) risk factors, we investigated the magnitude and duration of associated GBS risk. Methods We conducted a nationwide population-based case-control study of all patients with first-time hospital-diagnosed GBS in Denmark betwe...

Aims: To investigate temporal trends in time to initiation of sodium-glucose co-transporter-2 inhibitors and glucagon-like peptide 1 analogues (cardioprotective glucose-lowering drugs [GLDs]) in patients with a new dual diagnosis of type 2 diabetes (T2DM) and cardiovascular disease (CVD). Materials and methods: In a cohort study, we identified p...

Objective To investigate the association between newly developed type 2 diabetes (T2D) and incident psychopharmacological treatment and psychiatric hospital contact. Methods Via Danish registers, we identified all 56,640 individuals from the Central- and Northern Denmark Regions with newly developed T2D (defined by the first HbA 1c measurement ≥6....

Objective: Statins may reduce the risk of diabetic polyneuropathy (DPN) as a result of lipid-lowering and anti-inflammatory effects, but statins have also been associated with neurotoxicity. We examined whether statin therapy affects the risk of DPN. Research design and methods: We identified all Danish patients with incident type 2 diabetes dur...

Background Diabetic polyneuropathy (DPN) is a common complication of diabetes. Using the Toronto criteria for diabetic polyneuropathy and the grading system for neuropathic pain, we assessed the performance of neuropathy scales and questionnaires by comparing them to a clinical gold standard diagnosis of DPN and painful DPN in a cohort of patients...

Background Concerns over the safety of non-steroidal anti-inflammatory drug (NSAID) use during SARS-CoV-2 infection have been raised. Objectives To study whether use of NSAIDs is associated with adverse outcomes and mortality during SARS-CoV-2 infection. Design Population based cohort study Setting Danish administrative and health registries. Parti...

Background Individuals with type 2 diabetes (T2D) have a twofold increased risk for cardiovascular events (CVE), and CVE is responsible for nearly 80% of the mortality. Current treatment guidelines state that individuals should immediately initiate antidiabetic treatment and cardiovascular risk-factor management from T2D diagnosis. However, the evi...

Introduction: End-stage kidney disease (ESKD) is a life-threatening but preventable complication to diabetes and early detection of high-risk persons is essential. Our aim was to develop a prediction model for ESKD in type 1 diabetes (T1D). Materials and Methods: Detailed clinical- and lifestyle data from 5,460 Danish adults with T1D was linked to...

Objective: To investigate the association of metabolic and lifestyle factors with possible diabetic polyneuropathy (DPN) and neuropathic pain in patients with early type 2 diabetes. Research design and methods: We thoroughly characterized 6,726 patients with recently diagnosed diabetes. After a median of 2.8 years, we sent a detailed questionnai...

Background We investigated changes in clinical characteristics of SGLT2i and GLP-1RA real-world initiators in Denmark before/after landmark cardiovascular outcome trials. Methods We compared first-time SGLT2i (25,070) and GLP-1RA (14,671) initiators to initiators of DPP-4i (n = 34,079), a class without proven cardiovascular benefits. We used linke...

Background: Lactate is a robust prognostic marker for the outcome of critically ill patients. Several small studies reported that metformin users have higher lactate levels at ICU admission without a concomitant increase in mortality. However, this has not been investigated in a larger cohort. We aimed to determine whether the association between...

Importance Use of the sodium-glucose cotransporter 2 inhibitor empagliflozin has increased substantially since 2015. Little is known about characteristics of real-world patients who use empagliflozin or about empagliflozin’s effectiveness in reducing glycated hemoglobin (HbA1c) levels in routine clinical care. Objectives To characterize real-world...

Objective Little is known about the prognosis of infections in patients with ankylosing spondylitis (AS) compared with patients without AS. The purpose of this study was to examine whether AS is associated with poorer outcomes in patients who are hospitalised with pneumonia. Methods In a population-based cohort study including patients with hospit...

Objective Patients with rheumatoid arthritis (RA) experience an increased risk of infections, but the prognosis of infections is unclear. We examined if patients with RA have worse outcomes from pneumonia than non-RA individuals. Methods In a population-based cohort study, we computed 90-day mortality rates and crude and adjusted HRs comparing pne...

Background Routine clinical evidence is limited on clinical outcomes associated with anemia in patients with severe chronic kidney disease (CKD). Methods We linked population-based medical databases to identify individuals with severe CKD (eGFR < 30 mL/min/1.73 m²) in Northern Denmark from 2000 to 2016, including prevalent patients as of 1 January...

Objective To investigate the influence of acetylsalicylic acid (ASA) use on risk and outcome of community-acquired Staphylococcus aureus bacteremia (CA-SAB). Method We used population-based medical databases to identify all patients diagnosed in northern Denmark with first-time CA-SAB and matched population controls from 2000–2011. Categories for...

Objective: To examine 18-year trends in early A1C and lipid control among patients initiating first-time glucose-lowering drug therapy (GLD) for type 2 diabetes. Materials and Methods: Population-based sequential cross-sectional study using healthcare databases covering Northern Denmark (∼1.8 million persons). For all 94,175 GLD initiators during 2...

While diabetes is an important risk factor for breast cancer, less is known regarding whether a breast cancer diagnosis is associated with increased risk of subsequent diabetes. We therefore assessed the effect of a breast cancer diagnosis on incident diabetes, using population-level data from Danish healthcare registries during 2005-2016. Our stud...

Objectives: To investigate changes in clinical characteristics of SGLT2i and GLP-1RA initiators in Denmark before/after landmark trials. Materials and Methods: Compared first-time SGLT2i (25,070) and GLP-1RA (15,803) initiators to initiators of DPP-4i (without proven cardiovascular benefits), using linked population-based healthcare data to examine...

Background Pheochromocytomas and catecholamine-secreting paragangliomas (PPGL) are rare catecholamine-producing tumors. Due to the rarity, limited data on prognosis exists. Here, we present national data on mortality for radically operated patients compared to the background population over a period of 40 years. Materials and methods We have previo...

Aims/hypothesis The aim of this study was to examine the effect of Roux-en-Y gastric bypass (RYGB) surgery on diabetes remission, subsequent diabetes relapse and micro- and macrovascular complications in individuals with type 2 diabetes and obesity (BMI >35 kg/m²) in a real-world setting. Methods This was a population-based cohort study of 1111 in...

Objective It has been suggested that a hyper-effective immune system (“hyper-immunity”) is central to the pathogenesis of giant cell arteritis and polymyalgia rheumatica (GCA/PMR). We examined if a low risk of infections, as a marker of hyper-immunity, can predict increased subsequent risk of GCA/PMR. Patients and methods We conducted a population...

Objective Risk of venous thromboembolism (VTE) is increased in patients with hypo/hyperthyroidism. It is unknown whether VTE may be a presenting symptom of occult cancer in these patients. Design Nationwide population-based cohort study based on Danish medical registry data. Methods We identified all patients diagnosed with VTE during 1978–2013 w...

Background and Aims When investigating and treating asthma in children, diagnosing must be precise and valid. There is a need for studies researching asthma in children showing how to use registry‐based, epidemiological data. We examined the feasibility and validity of using anti‐asthmatic drug prescription data to identify children with asthma and...

Background Pheochromocytoma and catecholamine-secreting paraganglioma (PPGL) are rare but potentially life-threatening tumors. We aimed to validate diagnosis codes for PPGL in the Danish National Patient Registry, the Danish National Pathology Registry, and the Danish Registry of Causes of Death and to create a national cohort of incident PPGL pati...

Background: Data on the true burden of hyperkalemia in patients with heart failure (HF) in a real-world setting are limited. Methods and results: Incidence rates of hyperkalemia (first blood test with a potassium level >5.0 mmol/L) in primary or hospital care were assessed in a population-based cohort of patients with incident HF diagnoses in no...

Background Bupropion and varenicline can substantially improve the chances of smoking cessation in patients with COPD, but are unsubsidized and relatively costly. We examined overall use and socioeconomic patterns of use among patients with COPD. Patients and methods We identified 4,741 COPD patients reporting to be smokers at their first contact...

Aims To examine the incidence, risk factors and clinical outcomes of hyperkalaemia in people with diabetes in a real‐world setting. Methods Using Danish health registries, we identified a population‐based cohort of people with first‐time drug‐treated diabetes, in the period 2000−2012. First, the cumulative incidence of hyperkalaemia, defined as fi...

Table S1. Codes Used to Identify Study Variables Table S2. Baseline Characteristics of Patients With Incident Heart Failure in Northern Denmark, 2000–2012. Incidences of Any (>5.0 mmol/L), Moderate (>5.5 mmol/L), and Severe (>6.0 mmol/L) Hyperkalemia (HK) Events are Shown According to Each Characteristic Table S3. Prevalence and Prevalence Ratios...

Background Data are sparse on the range of BMI among patients acutely admitted to general hospitals. We investigated BMI values and associated patient characteristics, reasons for hospital admission, and mortality in Denmark. Methods We identified all persons with an acute inpatient admission 2011–2014 in Central Denmark Region and assessed BMI me...

Anatomical Therapeutic Chemical Classification System codes (ATC-codes) for prescription medications from the Danish National Prescription Health Service Database. (DOCX)

Prevalences of prehospital medication users in the cohort according to BMI category. (DOCX)

The 15 most common ICD-10 diagnoses at the three-digit level in the Danish National Patient Registry, according to body mass index category. (DOCX)

ICD-10 codes for conditions included in the Charlson Comorbidity Index. (DOCX)

Prevalence of comorbidities in the Charlson Comorbidity Score, by BMI category. (DOCX)

Diagnosis codes for selected diseases and according to ICD-10 chapters used for disease categories. (DOCX)

Purpose The aim of this article is to provide a detailed description of the ongoing nationwide Danish Centre for Strategic Research in Type 2 Diabetes (DD2) project cohort and biobank. The DD2 cohort continuously enrols newly diagnosed patients with type 2 diabetes (T2D) throughout Denmark. The overall goal of the DD2 project is to establish a larg...

Background: Latent Autoimmune Diabetes in Adults (LADA) is the second most common form of diabetes, but data on its clinical course and prognosis are scarce. We compared long-term risk of mortality and cardiovascular outcomes in patients with LADA, type 2 diabetes mellitus (T2D), and insulin deficient diabetes (IDD). Methods: We conducted a coho...

28th International Congress of the European-Respiratory-Society (ERS), Paris, FRANCE, SEP 15-19, 2018