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; Sia K Nicolaisen; Jens S Nielsen; Diana H Christensen; Kurt Højlund; Henning Beck-Nielsen; Jørgen Rungby; Søren G Friborg; Ivan Brandslund; Jens S Christiansen; Peter Vestergaard; Niels Jessen; Michael H Olsen; Mette K Andersen; Torben Hansen; Charlotte Brøns; Allan Vaag; Reimar W Thomsen; Henrik T Sørensen

doi:10.2147/CLEP.S469958

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

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

Authors

Frederik P B Kristensen¹, Sia K Nicolaisen¹, Jens S Nielsen^{2

3}, Diana H Christensen^{1

4}, Kurt Højlund^{2

3}, Henning Beck-Nielsen², Jørgen Rungby⁵, Søren G Friborg⁶, Ivan Brandslund^{7

8}, Jens S Christiansen⁴, Peter Vestergaard^{9

10}, Niels Jessen^{11

12

13}, Michael H Olsen^{14

15}, Mette K Andersen¹⁶, Torben Hansen¹⁶, Charlotte Brøns⁵, Allan Vaag^{5

17}, Reimar W Thomsen¹, Henrik T Sørensen¹

Affiliations

¹ Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Aarhus, Denmark.
² Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.
³ Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
⁴ Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark.
⁵ Steno Diabetes Center Copenhagen, Herlev, Denmark.
⁶ Department of Endocrinology, Odense University Hospital, Odense, Denmark.
⁷ Department of Biochemistry, Lillebaelt Hospital, Vejle, Denmark.
⁸ Regional Health Research, University of Southern Denmark, Odense, Denmark.
⁹ Department of Clinical Medicine and Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
¹⁰ Steno Diabetes Center North Denmark, Aalborg, Denmark.
¹¹ Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.
¹² Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark.
¹³ Department of Biomedicine, Aarhus University, Aarhus, Denmark.
¹⁴ Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
¹⁵ Department of Internal Medicine and Steno Diabetes Center Zealand, Holbæk Hospital, Holbæk, Denmark.
¹⁶ Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, København, Denmark.
¹⁷ Lund University Diabetes Centre, Lund University, Malmö, Sweden.

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.

Grants and funding

The Danish Centre for Strategic Research in Type 2 Diabetes Project is supported by the Danish Agency for Science (grant number: 09-067009, 10-079102, 09-075724), the Danish Health Authority, the Danish Medicines Agency, the Danish Diabetes Association, and Novo Nordisk Foundation (grant number: NNF17SA0030364, NNF16SA0024768, NNF20OC0063292)., NNF23SA0088557). Project partners are listed on the website www.DD2.dk. This work was also supported by a grant from the Novo Nordisk Foundation (NNF23SA0084103). Furthermore, this work has been supported partly by the Program for Clinical Research Infrastructure (PROCRIN) established by the Lundbeck Foundation and the Novo Nordisk Foundation.