scholarly journals Psychological Distress and Incidence of Type 2 Diabetes in High-Risk and Low-Risk Populations: The Whitehall II Cohort Study

Diabetes Care ◽  
2014 ◽  
Vol 37 (8) ◽  
pp. 2091-2097 ◽  
Author(s):  
Marianna Virtanen ◽  
Jane E. Ferrie ◽  
Adam G. Tabak ◽  
Tasnime N. Akbaraly ◽  
Jussi Vahtera ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Psychological Distress ◽  
High Risk ◽  
Low Risk

scholarly journals Temporal Trend in Young-Onset Type 2 Diabetes - the Macrovascular and Mortality Risk: Study of UK Primary Care Electronic Medical Records

2020 ◽  
Author(s):  
Digsu N. Koye ◽  
Joanna Ling ◽  
John Dibato ◽  
Kamlesh Khunti ◽  
Olga Montvida ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Risk Factor ◽  
High Risk ◽  
Mortality Risk ◽  
Cardiometabolic Risk ◽  
Low Risk ◽  
Young Onset ◽  
Onset Type

<b>Objectives: </b>To evaluate temporal prevalence trend, cardiometabolic risk factors, and the risk of atherosclerotic cardiovascular disease (ASCVD) and all-cause mortality (ACM) in incident young- and usual-onset type 2 diabetes. <p><b>Research Design and Methods: </b>From the UK primary care database, 370,854 people with new diagnosis of type 2 diabetes from 2000 to 2017 were identified. Analyses were conducted by age groups (18-39, 40-49, 50-59, 60-69, 70-79 years) and high/low risk status without history of ASCVD at diagnosis - ≥ two of current smoking, high SBP, high LDL-C or chronic kidney disease were classified as high-risk. </p> <p><b>Results:</b> Proportion of people aged <50 years at diagnosis increased during 2000-2010 and then stabilised. The incidence rates of ASCVD and ACM declined in people aged ≥50 years, but did not decrease in people <50 years. Compared to people aged ≥50 years, those aged 18-39 years at diagnosis had higher obesity (71% obese), higher HbA1c (8.6%), 71% had high LDL-C, while only 18% were on cardio-protective therapy. Although 2% in this age group had ASCVD at diagnosis, 23% were identified as high-risk. In the 18-39 years group, the adjusted average years to ASCVD /ACM in high-risk individuals (years (95% CI): 9.1 (8.2–10.0) /9.3 (8.1–10.4)) were similar to those with low-risk (years (95% CI): 10.0 (9.5 – 10.5) /10.5 (9.7–11.2)). However, individuals ≥50 years with high-risk were likely to experience an ASCVD event 1.5 - 2 years earlier and death 1.1 – 1.5 years earlier compared to low-risk groups (p<0.01). </p> <p><b>Conclusions: </b>Unlike usual-onset,<b> </b>young-onset type 2 diabetes have similar cardiovascular and mortality risk irrespective of their cardiometabolic risk factor status at diagnosis. The guidelines on the management of young-onset type 2 diabetes for intensive risk-factor management and cardioprotective therapies need to be urgently re-evaluated through prospective studies.<b> </b></p>

Abstract 190: Use of Intensive Glycemic Management in Older Adults With Diabetes. An Analysis From the Diabetes Collaborative Registry

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Suzanne V Arnold ◽  
Kasia J Lipska ◽  
Jingyan Wang ◽  
Leo Seman ◽  
Sanjeev N Mehta ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
High Risk ◽  
Glucose Control ◽  
Low Risk ◽  
Minimal Risk ◽  
Tight Control ◽  
Poor Control ◽  
Intensively Managed

Background: Older adults with diabetes are less likely to benefit and more likely to be harmed by intensive glucose control. Prior research has shown that many older adults continue to be intensively managed despite guidelines that recommend that treatment targets should be relaxed in these patients. As many new agents have been introduced with minimal risk of hypoglycemia, we examined contemporary data to understand to what extent older patients with diabetes are still intensively managed with agents that can cause hypoglycemia. Methods: We examined A1c and treatment data in adults ≥75 years with type 2 diabetes from 151 US outpatient sites in DCR. Patients were categorized as poor control (A1c >9%), moderate control (A1c >8-9%), conservative control (A1c 7-8%), tight control/low-risk agents (A1c <7% on meds with low risk for hypoglycemia), and tight control/high-risk agents (A1c <7% on insulin, sulfonylureas, or meglitinides). Adults with A1c <7% on no glucose-lowering medications were excluded. We used hierarchical logistic regression to examine patient and site factors associated with tight control/high-risk agents vs. conservative control or tight control/low-risk agents. Results: Among 30,696 older adults with diabetes, 5,596 (18%) had moderate or poor control, 9,227 (30%) conservative control, 7,893 (26%) tight control/low-risk agents, and 7,980 (26%) tight control/high-risk agents (Fig. A). Older age, male sex, heart failure, chronic kidney disease, and coronary artery disease were each independently associated with a greater odds of tight control/high-risk agents (Fig. B). After adjusting for patient factors, there were no differences among practice specialties (endocrinology, primary care, cardiology) in how aggressively patients were managed. Conclusion: Despite greater availability of agents that do not cause hypoglycemia, a quarter of older adults with type 2 diabetes are tightly controlled with high-risk medications. These results suggest potential overtreatment of a substantial proportion of patients. Efforts are needed to provide more specific guidance on how to safely treat older adults with diabetes (both through targeting treatment with low-risk agents and through de-escalation of glucose control) and then to efficiently translate that guidance into busy clinical practice.

scholarly journals MO048MULTICENTRE PROSPECTIVE VALIDATION OF THE URINARY PEPTIDOME-BASED CLASSIFIER CKD273 AS A PREDICTOR OF RENAL FUNCTION DECLINE IN SUBJECTS WITH TYPE 2 DIABETES

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Morten Lindhardt ◽  
Nete Tofte ◽  
Gemma Currie ◽  
Marie Frimodt-Moeller ◽  
Heiko Von der Leyen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Renal Function ◽  
High Risk ◽  
Risk Group ◽  
Cox Model ◽  
Risk Groups ◽  
High Risk Group ◽  
Low Risk ◽  
Renal Function Decline

Abstract Background and Aims In the PRIORITY study, it was recently demonstrated that the urinary peptidome-based classifier CKD273 was associated with increased risk for progression to microalbuminuria. As a prespecified secondary outcome, we aim to evaluate the classifier CKD273 as a determinant of relative reductions in eGFR (CKD-EPI) of 30% and 40% from baseline, at one timepoint without requirements of confirmation. Method The ‘Proteomic prediction and Renin angiotensin aldosterone system Inhibition prevention Of early diabetic nephRopathy In TYpe 2 diabetic patients with normoalbuminuria trial’ (PRIORITY) is the first prospective observational study to evaluate the early detection of diabetic kidney disease in subjects with type 2 diabetes (T2D) and normoalbuminuria using the CKD273 classifier. Setting 1775 subjects from 15 European sites with a mean follow-up time of 2.6 years (minimum of 7 days and a maximum of 4.3 years). Patients Subjects with T2D, normoalbuminuria and estimated glomerular filtration rate (eGFR) ≥ 45 ml/min/1.73m2. Participants were stratified into high- or low-risk groups based on their CKD273 score in a urine sample at screening (high-risk defined as score &gt; 0.154). Results In total, 12 % (n = 216) of the subjects had a high-risk proteomic pattern. Mean (SD) baseline eGFR was 88 (15) ml/min/1.73m2 in the low-risk group and 81 (17) ml/min/1.73m2 in the high-risk group (p &lt; 0.01). Baseline median (interquartile range) urinary albumin to creatinine ratio (UACR) was 5 (3-8) mg/g and 7 (4-12) mg/g in the low-risk and high-risk groups, respectively (p &lt; 0.01). A 30 % reduction in eGFR from baseline was seen in 42 (19.4 %) subjects in the high-risk group as compared to 62 (3.9 %) in the low-risk group (p &lt; 0.0001). In an unadjusted Cox-model the hazard ratio (HR) for the high-risk group was 5.7, 95 % confidence interval (CI) (3.9 to 8.5; p&lt;0.0001). After adjustment for baseline eGFR and UACR, the HR was 5.2, 95 % CI (3.4 to 7.8; p&lt;0.0001). A 40 % reduction in eGFR was seen in 15 (6.9 %) subjects in the high-risk group whereas 22 (1.4 %) in the low-risk group developed this endpoint (p&lt;0.0001). In an unadjusted Cox-model the HR for the high-risk group was 5.0, 95 % CI (2.6 to 9.6; p&lt;0.0001). After adjustment for baseline eGFR and UACR, the HR was 4.8, 95 % CI (2.4 to 9.7; p&lt;0.0001). Conclusion In normoalbuminuric subjects with T2D, the urinary proteomic classifier CKD273 predicts renal function decline of 30 % and 40 %, independent of baseline eGFR and albuminuria.

A simple risk score identifies individuals at high risk of developing Type 2 diabetes: a prospective cohort study

2008 ◽  
Vol 25 (3) ◽  
pp. 191-196 ◽  
Author(s):  
M. Rahman ◽  
R. K. Simmons ◽  
A.-H. Harding ◽  
N. J. Wareham ◽  
S. J. Griffin
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
High Risk ◽  
Prospective Cohort Study ◽  
Risk Score ◽  
Prospective Cohort

scholarly journals Determinants of 20-year non-progression to Type 2 diabetes in women at very high risk: the E3N cohort study

2018 ◽  
Vol 35 (12) ◽  
pp. 1716-1721 ◽  
Author(s):  
G. Fagherazzi ◽  
G. Gusto ◽  
F. R. Mancini ◽  
C. Dow ◽  
K. Rajaobelina ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
High Risk ◽  
Very High

scholarly journals The Relationship between the Risks of Developing Type 2 Diabetes Mellitus and Cardiovascular Diseases

2020 ◽  
Vol 14 (1) ◽  
pp. 13-17
Author(s):  
Carlos Sotomayor-Beltran ◽  
Rosa Perez-Siguas ◽  
Eduardo Matta-Solis ◽  
Hernan Matta-Solis
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cardiovascular Diseases ◽  
High Risk ◽  
Healthcare Facility ◽  
Low Risk ◽  
Exact Test ◽  
Significant Difference

Background: Type 2 Diabetes Mellitus (T2DM) has significantly increased in the past decades due to changes in lifestyles. This chronic disease is expected to be ranked in the seventh position by the year 2030 among the 15 leading causes of death. Poorly treated T2DM can be an important risk factor for cardiovascular diseases as well (CVD). Objective: We have sought to determine a relationship between the risks of developing T2DM and CVD in a healthcare facility in the district of Breña (Lima, Peru). Methods: The Finnish Diabetes Risk Score survey and the Pan American Health Organization risk calculator were used on a sample of 150 patients. The inclusion criteria were: patient age 40-80 years, attended their medical appointment more than once, were overweight or showed cholesterol levels above normal values and lived within the catchment area of the healthcare center where the study was carried out. Results: Only 8.7% of our sample was at a low risk of developing T2DM, whereas the rest was at a slightly elevated, moderate and high risk. Additionally, 79.3% of the patients were at low risk of developing CVD. Using the Fisher’s Exact test, there was a significant difference (p=0.026) between the risk grading of developing T2DM and CVD. Conclusion: The risk of developing CVD in our population is expected to rise in the future due to the already observed high risk of developing T2DM. It is hoped that this work serves Peruvian (and other) health authorities to bolster their prevention programs, especially focusing on lifestyle interventions (e.g. increased physical activity), which have proven to be successful and economical.

scholarly journals New Users of Metformin Are at Low Risk of Incident Cancer: A cohort study among people with type 2 diabetes

Diabetes Care ◽  
2009 ◽  
Vol 32 (9) ◽  
pp. 1620-1625 ◽  
Author(s):  
G. Libby ◽  
L. A. Donnelly ◽  
P. T. Donnan ◽  
D. R. Alessi ◽  
A. D. Morris ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Low Risk ◽  
Incident Cancer

scholarly journals Body Weight, Metabolic Dysfunction, and Risk of Type 2 Diabetes in Patients at High Risk for Cardiovascular Events or With Manifest Cardiovascular Disease: A Cohort Study

Diabetes Care ◽  
2015 ◽  
Vol 38 (10) ◽  
pp. 1945-1951 ◽  
Author(s):  
Bas T. Franssens ◽  
Yolanda van der Graaf ◽  
L. Jaap Kappelle ◽  
Jan Westerink ◽  
Gert J. de Borst ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Body Weight ◽  
Cohort Study ◽  
High Risk ◽  
Cardiovascular Events ◽  
Metabolic Dysfunction
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