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Articles by J. B. L. Hoekstra
Total Records ( 2 ) for J. B. L. Hoekstra
  W. M. Admiraal , I. G. M. van Valkengoed , J. S. L de Munter , K. Stronks , J. B. L. Hoekstra and F. Holleman
  Aims  To study differences in the association between physical inactivity and Type 2 diabetes among subjects from different ethnic groups.

Methods  We analysed data on 508 Caucasian, 596 African-Surinamese and 339 Hindustani-Surinamese participants, aged 35-60 years, in the population-based, cross-sectional Surinamese in the Netherlands Study on Health and Ethnicity (SUNSET) study. Physical inactivity was defined as the lowest quartile of reported activity, measured with the validated Short Questionnaire to Assess Health-Enhancing Physical Activity. Type 2 diabetes was defined as fasting plasma glucose levels ≥ 7.0 mmol/l or self-reported diagnosis.

Results  Physical inactivity was associated with Type 2 diabetes (OR 1.63, 95% CI 1.12-2.38) in the total group after adjustment for sex, age, BMI, ethnicity, resting heart rate, hypertension, smoking, history of cardiovascular disease, having a first-degree relative with Type 2 diabetes and educational level. However, this association was only significant in Caucasians (OR 3.17, 95% CI 1.37-7.30). Moreover, it appeared stronger in Caucasians than in Hindustani-Surinamese (OR 1.43, 95% CI 0.78-2.63) and African-Surinamese (OR 1.13, 95% CI 0.58-2.19), although the P-value for interaction was not significant.

Conclusions  Physical inactivity was associated with Type 2 diabetes in the total group after adjustment for multiple risk factors, but this association was only significant in Caucasians. Also, it appeared stronger in Caucasians than in Hindustani and African-Surinamese, but formal testing for interaction provided no further evidence. These findings confirm the importance of exercise, but suggest that potential health gain may differ between ethnic groups. However, it should be noted that, in general, promotion of physical activity in populations with an increased a priori risk of Type 2 diabetes, remains of the utmost importance.

  J. Hermanides , K. Norgaard , D. Bruttomesso , C. Mathieu , A. Frid , C. M. Dayan , P. Diem , C. Fermon , I. M. E. Wentholt , J. B. L. Hoekstra and J. H. DeVries
  Aims  To investigate the efficacy of sensor-augmented pump therapy vs. multiple daily injection therapy in patients with suboptimally controlled Type 1 diabetes.

Methods  In this investigator-initiated multi-centre trial (the Eurythmics Trial) in eight outpatient centres in Europe, we randomized 83 patients with Type 1 diabetes (40 women) currently treated with multiple daily injections, age 18-65 years and HbA1c≥ 8.2% (≥ 66 mmol/mol) to 26 weeks of treatment with either a sensor-augmented insulin pump (n = 44) (Paradigm® REAL-Time) or continued with multiple daily injections (n = 39). Change in HbA1c between baseline and 26 weeks, sensor-derived endpoints and patient-reported outcomes were assessed.

Results  The trial was completed by 43/44 (98%) patients in the sensor-augmented insulin pump group and 35/39 (90%) patients in the multiple daily injections group. Mean HbA1c at baseline and at 26 weeks changed from 8.46% (sd 0.95) (69 mmol/mol) to 7.23% (sd 0.65) (56 mmol/mol) in the sensor-augmented insulin pump group and from 8.59% (sd 0.82) (70 mmol/mol) to 8.46% (sd 1.04) (69 mmol/mol) in the multiple daily injections group. Mean difference in change in HbA1c after 26 weeks was −1.21% (95% confidence interval -1.52 to -0.90, < 0.001) in favour of the sensor-augmented insulin pump group. This was achieved without an increase in percentage of time spent in hypoglycaemia: between-group difference 0.0% (95% confidence interval -1.6 to 1.7, = 0.96). There were four episodes of severe hypoglycaemia in the sensor-augmented insulin pump group and one episode in the multiple daily injections group (= 0.21). Problem Areas in Diabetes and Diabetes Treatment Satisfaction Questionnaire scores improved in the sensor-augmented insulin pump group.

Conclusions  Sensor augmented pump therapy effectively lowers HbA1c in patients with Type 1 diabetes suboptimally controlled with multiple daily injections.

 
 
 
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