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. 2024 Sep 25:16:641-656.
doi: 10.2147/CLEP.S469958. eCollection 2024.

The Danish Centre for Strategic Research in Type 2 Diabetes (DD2) Project Cohort and Biobank from 2010 Through 2023-A Cohort Profile Update

Frederik P B Kristensen  1 , Sia K Nicolaisen  1 , Jens S Nielsen  2   3 , Diana H Christensen  1   4 , Kurt Højlund  2   3 , Henning Beck-Nielsen  2 , Jørgen Rungby  5 , Søren G Friborg  6 , Ivan Brandslund  7   8 , Jens S Christiansen  4 , Peter Vestergaard  9   10 , Niels Jessen  11   12   13 , Michael H Olsen  14   15 , Mette K Andersen  16 , Torben Hansen  16 , Charlotte Brøns  5 , Allan Vaag  5   17 , Reimar W Thomsen  1 , Henrik T Sørensen  1
Affiliations

The Danish Centre for Strategic Research in Type 2 Diabetes (DD2) Project Cohort and Biobank from 2010 Through 2023-A Cohort Profile Update

Frederik P B Kristensen et al. Clin Epidemiol. .

Abstract

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 diabetes mellitus (T2DM) recently diagnosed by general practitioners and by hospital-based clinicians across Denmark. Data from questionnaires, clinical examinations, and biological samples are collected at enrollment. Additional baseline and longitudinal follow-up data are accessed via linkage to health registries.

Results: Between 2010 and 2023, the DD2 project enrolled 11,369 participants (41.3% women, median age 61.4 years). Median T2DM duration at enrollment was 1.3 years, and median BMI was 31.6 kg/m2 for women and 30.5 kg/m2 for men. 18.3% were smokers, 5.7% consumed more than 14/21 units of alcohol weekly (women/men), and 17.9% reported leisure-time physical inactivity. Original midwife records dating back >80 years revealed that 20.2% of cohort participants had birth weights <3000 g. Based on complete hospital contact history 10 years before enrollment, 20.7% of cohort participants had macrovascular complications, 17.0% had microvascular complications, and 21.7% had kidney disease based on eGFR or urine albumin-creatinine measurements. At enrollment, statins were used by 68.2%, antihypertensive drugs by 69.9%, and glucose-lowering drugs by 86.5% of individuals. Median HbA1c was 48 mmol/mol and median LDL cholesterol 2.2 mmol/L. Genome-wide genotyping and biomarker data have been analyzed for over 9000 individuals. During the current follow-up time from the enrollment date (median 7.9 years), incident cardiovascular disease rate has been 13.8 per 1000 person-years and the mortality rate has been 17.6 per 1000 person-years.

Conclusion: The DD2 cohort, with its detailed information and long-term follow up, can improve our understanding of the progression and prevention of complications among individuals with newly diagnosed T2DM.

Keywords: Denmark; cohort profile; patient characteristics; type 2 diabetes mellitus.

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Conflict of interest statement

D.H.C reports grants from the Danish Diabetes and Endocrine Academy, outside the submitted work. I.B. is a partner in the DD2 project and received funding from DD2 to host and manage the DD2 Biobank. P.V. is head of research at Steno Diabetes Center North Denmark funded by an unrestricted grant from the Novo Nordisk Foundation. M.H.O. reports personal fees from Novo Nordic A/S, Teva A/S, AstraZeneca A/S, and Boehringer & Ingelheim, outside the submitted work. C.B. is a stock owner of Novo Nordisk. The Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, receives funding for other studies from companies in the form of research grants to (and administered by) Aarhus University. None of those studies have any relation to the present study. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Overview of data sources in the DD2 cohort.
Figure 2
Figure 2
Cumulative and annual number of participants enrolled in the DD2 project from 2010 to April 2023.
Figure 3
Figure 3
Risk of mortality and incident cardiovascular disease after enrollment in the DD2 cohort. Incident cardiovascular disease events include acute myocardial infarction, unstable angina, heart failure, coronary artery bypass grafting/percutaneous coronary intervention procedures, stroke, and cerebral thrombolysis/thrombectomy procedures. Patients were excluded from the analysis of cardiovascular disease if they had a preexisting hospital diagnosis or procedure code before baseline (N=1797). The Kaplan Meier estimator was used to depict all-cause mortality, and the Aalen-Johansen estimator was used for cardiovascular disease, taking the competing risk of death into consideration.
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