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INTRODUCTION: The incidence of type 2 diabetes mellitus (T2DM) is increasing, in parallel with the epidemic of obesity. Although bariatric surgery, which profoundly affects T2DM, has increased 10-fold since the millennium, only a fraction of diabetics is offered this treatment option. OBJECTIVE: To investigate the association between clinical and socioeconomic factors in selecting patients with T2DM for bariatric surgery in a publicly financed healthcare system. RESEARCH DESIGN AND METHODS: Cohort study using prospectively registered data from two nationwide quality registers, the Scandinavian Obesity Surgery Registry (SOReg) and the Swedish National Diabetes Register (NDR), and data from two government agencies. An age, gender and body mass index-matched case-control analysis containing 10 642 patients with T2DM was performed. RESULTS: Patients with T2DM having bariatric surgery had a higher education level (upper secondary school or college level, OR 1.42% and 95% CI (1.29 to 1.57) and 1.33 (1.18 to 1.51), respectively) as well as a higher income (OR 1.37 (1.22 to 1.53) to 1.94 (1.72 to 2.18) for quartile 2–4) than non-operated patients. Operated patients were more often married or had been married (OR 1.51 (1.37 to 1.66) and 1.65 (1.46 to 1.86), respectively) as well as natives (OR 0.84 (0.73 to 0.95) if born in the rest of Europe). Groups did not differ regarding relevant laboratory data and present medication, nor in former in-patient diagnoses. CONCLUSION: Despite similar clinical data, superior socioeconomic status was associated with increased rate of bariatric surgery in patients with T2DM. We believe that this warrants actions, for example concerning referral patterns.

OBJECTIVE To evaluate if the lowest target level for glycated haemoglobin (HbA(1c)) of amp;lt; 6.5% is associated with lower risk for retinopathy and nephropathy than less tight control in children and adults with type 1 diabetes. DESIGN Population based cohort study. SETTING Swedish National Diabetes Registry, 1 January 1998 to 31 December 2017. PARTICIPANTS 10 398 children and adults with type 1 diabetes followed from diagnosis, or close thereafter, until end of 2017. MAIN OUTCOME MEASURES Relative risk (odds ratios) for retinopathy and nephropathy for different mean levels of HbA(1c). RESULTS Mean age of participants was 14.7 years (43.4% female), mean duration of diabetes was 1.3 years, and mean HbA(1c) level was 8.0% (63.4 mmol/mol). After adjustment for age, sex, duration of diabetes, blood pressure, blood lipid levels, body mass index, and smoking, the odds ratio for mean HbA(1c) amp;lt; 6.5% (amp;lt; 48 mmol/mol) compared with 6.5-6.9% (48-52 mmol/mol) for any retinopathy (simplex or worse) was 0.77 (95% confidence interval 0.56 to 1.05, P=0.10), for preproliferative diabetic retinopathy or worse was 3.29 (0.99 to 10.96, P=0.05), for proliferative diabetic retinopathy was 2.48 (0.71 to 8.62, P=0.15), for microalbuminuria or worse was 0.98 (0.60 to 1.61, P=0.95), and for macroalbuminuria was 2.47 (0.69 to 8.87, P=0.17). Compared with HbA(1c) levels 6.56.9%, HbA(1c) levels 7.0-7.4% (53-57 mmol/mol) were associated with an increased risk of any retinopathy (1.31, 1.05 to 1.64, P=0.02) and microalbuminuria (1.55, 1.03 to 2.32, P=0.03). The risk for proliferative retinopathy (5.98, 2.10 to 17.06, Pamp;lt;0.001) and macroalbuminuria (3.43, 1.14 to 10.26, P=0.03) increased at HbA(1c) levels amp;gt; 8.6% (amp;gt; 70 mmol/mol). The risk for severe hypoglycaemia was increased at mean HbA(1c) amp;lt; 6.5% compared with 6.5-6.9% (relative risk 1.34, 95% confidence interval 1.09 to 1.64, P=0.005). CONCLUSIONS Risk of retinopathy and nephropathy did not differ at HbA(1c) levels amp;lt; 6.5% but increased for severe hypoglycaemia compared with HbA(1c) levels 6.5-6.9%. The risk for severe complications mainly occurred at HbA(1c) levels amp;gt; 8.6%, but for milder complications was increased at HbA(1c) levels amp;gt; 7.0%. ; Funding Agencies|Swedish government; Novonordisk Foundation

Aims Albuminuria is strongly associated with risk of renal dysfunction, cardiovascular disease and mortality. However, clinical guidelines diverge, and evidence is sparse on what risk factor levels regarding blood pressure, blood lipids and BMI are needed to prevent albuminuria in adolescents and young adults with type 1 diabetes. Methods A total of 9347 children and adults with type 1 diabetes [mean age 15.3 years and mean diabetes duration 1.4 years at start of follow-up] from The Swedish National Diabetes Registry were followed from first registration until end of 2017. Levels for risk factors for a risk increase in nephropathy were evaluated, and the gradient of risk per 1 SD (standard deviation) was estimated to compare the impact of each risk factor. Results During the follow-up period, 8610 (92.1%) remained normoalbuminuric, 737 (7.9%) individuals developed micro- or macroalbuminuria at any time period of whom 132 (17.9% of 737) individuals developed macroalbuminuria. Blood pressure >= 140/80 mmHg was associated with increased risk of albuminuria (p = 1.0 mmol/L (p = 0.039), total cholesterol >= 5.0 mmol/L (p = 0.0003), HDL = 30 kg/m(2) (p = 0.033). HbA1c was the strongest risk factor for any albuminuria estimated by the measure gradient of risk per 1 SD, followed by diastolic blood pressure, triglycerides, systolic blood pressure, cholesterol and LDL. In patients with HbA1c > 65 mmol/mol (> 8.1%), blood pressure > 140/70 mmHg was associated with increased risk of albuminuria. Conclusions Preventing renal complications in adolescents and young adults with type 1 diabetes need avoidance at relatively high levels of blood pressure, blood lipids and BMI, whereas very tight control is not associated with further risk reduction. For patients with long-term poor glycaemic control, stricter blood pressure control is advocated. ; Funding Agencies|University of Gothenburg; Swedish government; Novo Nordisk FoundationNovo Nordisk FoundationNovocure Limited

Includes the following reviews:
pp. 116-117. Karin Aijmer. Carter, R. & McCarthy, M., Exploring Spoken English.
pp. 117-118. Karin Aijmer. Knowles, G., Wichmann, A. & Alderson, P. (eds), Working wirh Speech.
pp. 118-121. Arne Olofsson. Barlach, E., Call English, An English Grammar for Danish Students.
pp. 121-123. Marko Modiano. Honey, J., Language is Power: The Story of Standard English and its Enemies.
p. 123. Ann-Marie Svensson. Freeborn, D., From Old English to Standard English.
pp. 124-126. Magnus Ankarsjö. Homer, S., Fredric Jameson: Marxism, Hermeneutics, Postmodernism.
pp. 126-127. Monica Armini. Cixous, H., Stigmata: Escaping Texts.
pp. 127-128. Sabina Kielow. Browning, B., Infectious Rythm: Metaphors of Contagion and the Spread of African Culture. + Kanneh, K., African Identities: Race, Nation and Culture in Ethnography.
p. 128. Ronald Paul. Jameson, F., The Cultural Turn: Selected Writings on the Postmodern, 1983-1998.
pp. 129-130. Andrea Kalman. Åhlander, L., Lömska ord och fällor - tysk ordkunskap.
pp. 131-132. Oliver Jahraus. Nünning, A. (Hrsg.), Metzler Lexikon, Literatur und Kulturtheorie, Ansätze - Personen - Grundbegriffe.
pp. 132-135. Tom Conner. Lucey, M., Gide's Bent. Sexuality, Politics, Writing.
pp. 135-136. Tom Conner. Kerdellant, CH., Les chroniques de l'ingénieur Norton. Condidences d'un Américain à Paris.

Background Socioeconomic status, origin or demographic attributes shall not determine the quality of healthcare delivery, according to e.g. United Nations and European Union rules. Health equity has been defined as the absence of systematic disparities and unwarranted differences between groups defined by differences in social advantages. A study was performed to investigate whether this was applicable to type 1 diabetes mellitus (T1D) care in a setting with universal, tax-funded healthcare. Methods This retrospective registry-study was based on patient-level data from individuals diagnosed with T1D during 2010-2011 (n = 16,367) in any of seven Swedish county councils (covering -65% of the Swedish population). Health equity in T1D care was analysed through multivariate regression analyses on absolute HbA1c level at one-year follow-up, one-year change in estimated glomerular filtration rate (eGFR) and one-year change in cardiovascular risk score, using selected sociodemographic dimensions as case-mix factors. Results Higher educational level was consistently associated with lower levels of HbA1c, and so was being married. Never married was associated with worse eGFR development, and lower educational level was associated with higher cardiovascular risk. Women had higher HbA1c levels than men, and glucose control was significantly worse in patients below the age of 25. Conclusion Patients' sociodemographic profile was strongly associated with absolute levels of risk factor control in T1 D, but also with an increased annual deterioration in eGFR. Whether these systematic differences stem from patient-related problems or healthcare organisational shortcomings is a matter for further research. The results, though, highlight the need for intensified diabetes management education and secondary prevention directed towards T1D patients, taking sociodemographic characteristics into account.

Background: Socioeconomic status, origin or demographic attributes shall not determine the quality of healthcare delivery, according to e.g. United Nations and European Union rules. Health equity has been defined as the absence of systematic disparities and unwarranted differences between groups defined by differences in social advantages. A study was performed to investigate whether this was applicable to type 1 diabetes mellitus (T1D) care in a setting with universal, tax-funded healthcare. Methods: This retrospective registry-study was based on patient-level data from individuals diagnosed with T1D during 2010-2011 (n = 16,367) in any of seven Swedish county councils (covering -65% of the Swedish population). Health equity in T1D care was analysed through multivariate regression analyses on absolute HbA1c level at one-year follow-up, one-year change in estimated glomerular filtration rate (eGFR) and one-year change in cardiovascular risk score, using selected sociodemographic dimensions as case-mix factors. Results: Higher educational level was consistently associated with lower levels of HbA1c, and so was being married. Never married was associated with worse eGFR development, and lower educational level was associated with higher cardiovascular risk. Women had higher HbA1c levels than men, and glucose control was significantly worse in patients below the age of 25. Conclusion: Patients' sociodemographic profile was strongly associated with absolute levels of risk factor control in T1 D, but also with an increased annual deterioration in eGFR. Whether these systematic differences stem from patient-related problems or healthcare organisational shortcomings is a matter for further research. The results, though, highlight the need for intensified diabetes management education and secondary prevention directed towards T1D patients, taking sociodemographic characteristics into account.

Includes the following reviews:pp. 100-102. Göran Kjellmer. Hill, J. & Lewis, M. (eds), Dictionary of Selected Collocations.
pp. 102-103. Ann-Marie Svensson. Lass, R., Historical linguistics and language change.
p. 103. Monica Malm. Cixous, H. & Calle-Gruber, M., Rootprints: Memory and Life Writing.
p. 104. Paul Goulding. Storry, M. & Childs, P. (ed.), British Cultural Identities.
p. 105. Ronald Paul. Young, G., From Sea to Shining Sea: a present-day journey into America's past.
pp. 105-106. Monica Malm. Coupe, L., Myth.
pp. 106-107. Nathaniel Chase. Modiano, M., A Mid-Atlantic Handbook. American and British English.
p. 107. Alan McGee. Bowen, T., Build Your Business Grammar.
pp. 107-108. Alan McGee. Comfort, J., Effective Socializing.
pp. 108. Alan McGee. Mackenzie, I., Management and Marketing.
pp. 109-110. Edelgard Biedermann. Besch, W., Duzen, Siezen, Titulieren: Zur Anrede im Deutschen heute und gestern.
pp. 110-111. Stefan Neuhaus. Cumart, N., Zwei Welten. Gedichte.
pp. 112-113. Stefan Neuhaus. Fontane, T., Englischer Sommer.
pp. 113-115. Hans-Roland Johnsson. Brown, F., Zola, A Life.
pp. 115-118. Karl-Anders Arvidsson. Le Nouveau Petit Robert électronique.
pp. 118-120. Gabriella Villagrán Backman. Foster, D.W., Mexican Literature: A History.

Includes the following reviews:
p. 101. Ann-Marie Svensson. Lightfoot, D., The Development of Language, Acquisition, Change, and Evolution.
p. 101-103. Marko Modiano. Ronowicz, E. & Yallop, C. (eds), English: One Language, Different Cultures.
p. 103-105. Angela Karstadt. Klintborg, S., The Transience of American English.
p. 105-106. Mats Mobärg. Pinker, S., Words and Rules. The Ingredients of Language.
p. 106-107. Åke Persson. Cartmell, D. & Whelehan, I. (eds), Adaptations: From Text to Screen, Screen to Text.
p. 108. Monica Armini. Rivkin, J. & Ryan, M. (eds), Literary Theory: An Anthology.
p. 108-109. Peter Boxall. Paul, R., Dissonant Voices: Literature and Society in Britain from Chaucer to the Present Day.
p. 109-110. Maria Proitsaki. Dove, R., On the Bus with Rosa Parks.
p. 110-111. Ronald Paul. Arundhati, R., The Cost of Living.
p. 111. Sabina Kielow. Chouliaraki, L. & Fairclough, N., Discourse in late Modernity: Rethinking Critical Discourse Analysis. + Mills, S., Discourse. The New Critical Idiom.
p. 112-114. Lars-Olof Nyhlén. Ammon, U. Ist deutsch noch internationale Wissenschaftssprache?
p. 114-115. Sigurd Rothstein. Treichel, H. -U., Der Verlone.
p. 116-117. M. Martin Guiney. Horlitz, M. Germanistische Schlaglichter.
p. 118-119. M. Martin Guiney. Conner, T., Chateaubriand's Mémoires d'outre-tombe. A portrait of the Artist as Exile.