Mortality Risk in Spanish Adults With Diagnosed Diabetes, Undiagnosed Diabetes, or Pre-Diabetes. The Asturias Study 1998-2004

Valdés, Sergio; Botas, Patricia; Delgado, Elias; Cadórniga, F. Díaz

doi:10.1016/s1885-5857(09)71835-3

Cited by 19 publications

(24 citation statements)

References 18 publications

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“…Of those with a confirmed diagnosis by the doctor, 80% actually received antidiabetic treatment. This finding is in line with the Spanish Asturias Study, where only 60% of the subjects with previously undiagnosed diabetes actually informed their treating physicians about their new diagnosis [4]. An additional factor related to diabetes treatment refers to potential differences in health consciousness.…”

Section: All-cause Mortality In Known and Undiagnosed Diabetessupporting

confidence: 81%

“…In the Edinburgh Artery Study cohort with a study population in the same age range (i.e., 55-74 years), HR for known diabetes (1.75; 95%CI, 1.15-2.67) was only slightly larger than that for newly detected diabetes (1.60; 95%CI, 1.20-2.13) after adjustment for age and sex [6]. In the Asturias and the DECODE studies, both including participants of middle and old ages, similar mortality risks were also found for known and undiagnosed diabetes [4,5]. By contrast, mortality risks in the AusDiab study were higher for known diabetes than for previously undiagnosed diabetes [26].…”

Section: All-cause Mortality In Known and Undiagnosed Diabetesmentioning

confidence: 68%

“…Among the older participants of the German KORA S4 study, the proportion of undiagnosed diabetes also turned out to be high [3]. In some studies, similar all-cause mortality risks were found in subjects with known and previously undiagnosed diabetes [4][5][6]. However, in an older study with DECODE data, results depended on glucose classification [7], and in another study with NHANES II (US) data, lower risks for all-cause and cardiovascular mortality were seen in undiagnosed diabetes compared with diagnosed diabetes [8].…”

Section: Introductionmentioning

confidence: 91%

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Categories of glucose tolerance and continuous glycemic measures and mortality

et al. 2011

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We investigated the association of undiagnosed diabetes, previously known diabetes and prediabetes (WHO 1999 classification) with all-cause and cause-specific mortality in an older German population. Previous study results for mortality in patients with very low levels of HbA1c, fasting plasma glucose (FPG), and 2-h plasma glucose (2hPG) are still inconclusive. Thus we have extended the analyses to continuous measures of glycemia. A total of 1,466 subjects aged 55-74 years from the population-based KORA survey S4 (conducted from 1999 to 2001) were included in our observational mortality study (152 subjects with previously known diabetes, and 1,314 further subjects who underwent oral glucose tolerance tests). Mortality was followed up for a maximum of 10.0 years (median follow-up 8.8 years). A total of 180 (12.3%) of the 1,466 subjects have died during the follow-up period. The age- and sex-adjusted hazard ratios for all-cause mortality were 2.6 (95%CI, 1.7-3.8) for known diabetes, 2.8 (95%CI, 1.7-4.4) for undiagnosed diabetes, and 1.1 (95%CI, 0.8-1.7) for prediabetes [reference: normal glucose tolerance (NGT)]. After multivariable adjustment, undiagnosed diabetes was associated with 3.0-fold increased cancer mortality, 1.1-fold increased cardiovascular mortality, and 4.7-fold increased non-cancer, non-cardiovascular mortality compared with NGT. For HbA1c, FPG, and 2hPG, J-shaped associations with all-cause mortality were observed. Undiagnosed diabetes is associated with increased all-cause, cancer, and non-cancer non-cardiovascular mortality, but not with cardiovascular mortality in this older population. All-cause mortality in undiagnosed diabetes is similar to that in previously known diabetes but much higher than mortality in prediabetes and NGT.

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Section: All-cause Mortality In Known and Undiagnosed Diabetessupporting

confidence: 81%

Section: All-cause Mortality In Known and Undiagnosed Diabetesmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 91%

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Categories of glucose tolerance and continuous glycemic measures and mortality

et al. 2011

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“…24 Undiagnosed DM has been reported to carry a similar risk of mortality to that of diagnosed DM. [25][26][27] However, the estimated prevalence depends on the method used. The WHO 1999 protocol is considered the gold standard for estimating undiagnosed DM, using measurements of FPG and 2-hour glucose.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and determinants of type 2 diabetes mellitus in a Greek adult population

Tsirona

Katsaros

Bargiota

et al. 2016

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the prevalence of diabetes mellitus (dM) is increasing worldwide reaching epidemic proportions. the aim of the present study was to estimate the prevalence of dM in thessaly, a large region of central Greece, and to extrapolate our results to the population of the entire country. A random sample of 805 adults (421 females and 384 men) living in thessaly, aged 18-80 years, was surveyed. After completing a questionnaire about health status and a thorough physical examination, a blood sample was obtained from each participant for biochemical analysis. Participants with fasting glucose levels between 100-125 mg/dl underwent an oral glucose tolerance test (oGtt). A second survey was also conducted, via telephone call-interviews, in a randomly selected sample age-and sex-stratified to the country's adult population in order to extrapolate the dM data from thessaly to the whole country. the frequency of dM based on patient history and fasting blood glucose levels was 6.96%, comparable to that observed in the telephone-based nationwide survey (7.38%, p=0.669). However, after the oGtt an additional 3.72% of the population had undiagnosed dM, increasing dM prevalence to 10.68% (age adjusted 11.77%). the prevalence of pre-diabetes was 8.70%, with impaired fasting glucose at 5.84% and impaired glucose tolerance at 2.86%. the prevalence of dM was significantly higher in men (14.58%) than in women (7.13%, p<0.001), increased with age in both sexes and was more prevalent in hypertensive (p<0.001) and obese subjects (p=0.001) and in those living in rural areas (p=0.003). In the multiple logistic regression analysis, significant predictors of pre-diabetes and dM together were age, homeostasis model of assessment of insulin resistance (HoMA-IR), alcohol consumption and educational status, whereas those of dM alone were age, HoMA-IR and triglycerides. extrapolating our data to the whole country, the age-adjusted prevalence of dM was estimated at 11.97% (men 13.98%, women 9.25%), clearly indicating a major public health problem.

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“…Glucose metabolism abnormalities involve a wide range of qualitative clinical settings that can globally be classified as impaired fasting glucose (IFG) when fasting glucose is N100 mg/dl, impaired glucose tolerance (IGT) if 2 h post-oral glucose tolerance test (OGTT) is 140-200 mg/dl and diabetes mellitus (DM) if fasting glucose is N126 mg/dl in two separate determinations or N200 mg after a OGTT [4]. Main clinical relevancy of IFG and IGT relies in two aspects: the high risk of mid-term new-onset DM [4,5] and the increased cardiovascular risk [6,7]. The accurate diagnosis of glucose metabolism and DM also has relevant clinical implications because the American Society of Diabetes recently recommended metformin initiation as soon as DM is diagnosed [8].…”

Section: Introductionmentioning

confidence: 99%