Criteria for previously undiagnosed diabetes and risk of mortality: 15 year follow-up of the Edinburgh Artery Study cohort

S. H. Wild, F. B. Smith, Amanda Jane Lee, F. G. R. Fowkes

Research output: Contribution to journalArticle

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Abstract

Aims To compare risk of all-cause and cardiovascular mortality associated with different criteria for undiagnosed diabetes and glucose tolerance.

Methods A population-based cohort of 758 men and 738 women of 55-74 years of age who had an oral glucose tolerance test or known diabetes at baseline were followed up until death or for 15 years. Mortality outcomes were compared by baseline diabetes status using people with normal glucose tolerance (i.e. those without diabetes, impaired fasting glucose or impaired glucose tolerance) as the reference group.

Results Prevalence of undiagnosed diabetes using World Health Organization (WHO) criteria (fasting glucose of >= 7.0 mmol/l and/or a 2-h post-challenge glucose of >= 11.1 mmol/l) was 6.6%, of which 81% was associated with fasting glucose >= 7.0 mmol/l and 19% was associated with isolated post-challenge hyperglycaemia. Hazard ratios (95% CI) for all-cause mortality adjusted for age and sex were 1.51 (1.09-2.08) for new diabetes by the American Diabetes Association (ADA) criterion (fasting glucose of >= 7.0 mmol/l regardless of post-challenge glucose), 1.60 (1.20-2.13) for new diabetes by WHO criteria and 1.98 (1.14-3.44) for isolated post-challenge hyperglycaemia. Hazard ratios (95% CI) for cardiovascular mortality adjusted for age and sex were 1.89 (1.17-3.00), 1.73 (1.12-2.66) and 1.08 (0.34-3.40) for new diabetes by ADA and WHO criteria and for isolated post-challenge hyperglycaemia, respectively.

Conclusions Undiagnosed diabetes was associated with increased risk of all-cause mortality by any criteria but significantly increased cardiovascular disease mortality was only associated with diabetes diagnosed using the fasting glucose criterion. Mortality risks were similar in this population using either ADA or WHO criteria for diagnosis of diabetes.

Original languageEnglish
Pages (from-to)490-496
Number of pages6
JournalDiabetic Medicine
Volume22
DOIs
Publication statusPublished - 2005

Keywords

  • diagnostic criteria
  • mortality
  • Type 2 diabetes mellitus
  • IMPAIRED GLUCOSE-TOLERANCE
  • CARDIOVASCULAR-DISEASE
  • DIAGNOSTIC-CRITERIA
  • GENERAL-POPULATION
  • HIGH PREVALENCE
  • MELLITUS
  • HYPERGLYCEMIA
  • HISTORY
  • ADULTS
  • HEALTH

Cite this

Criteria for previously undiagnosed diabetes and risk of mortality: 15 year follow-up of the Edinburgh Artery Study cohort. / Wild, S. H.; Smith, F. B.; Lee, Amanda Jane; Fowkes, F. G. R.

In: Diabetic Medicine, Vol. 22, 2005, p. 490-496.

Research output: Contribution to journalArticle

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abstract = "Aims To compare risk of all-cause and cardiovascular mortality associated with different criteria for undiagnosed diabetes and glucose tolerance.Methods A population-based cohort of 758 men and 738 women of 55-74 years of age who had an oral glucose tolerance test or known diabetes at baseline were followed up until death or for 15 years. Mortality outcomes were compared by baseline diabetes status using people with normal glucose tolerance (i.e. those without diabetes, impaired fasting glucose or impaired glucose tolerance) as the reference group.Results Prevalence of undiagnosed diabetes using World Health Organization (WHO) criteria (fasting glucose of >= 7.0 mmol/l and/or a 2-h post-challenge glucose of >= 11.1 mmol/l) was 6.6{\%}, of which 81{\%} was associated with fasting glucose >= 7.0 mmol/l and 19{\%} was associated with isolated post-challenge hyperglycaemia. Hazard ratios (95{\%} CI) for all-cause mortality adjusted for age and sex were 1.51 (1.09-2.08) for new diabetes by the American Diabetes Association (ADA) criterion (fasting glucose of >= 7.0 mmol/l regardless of post-challenge glucose), 1.60 (1.20-2.13) for new diabetes by WHO criteria and 1.98 (1.14-3.44) for isolated post-challenge hyperglycaemia. Hazard ratios (95{\%} CI) for cardiovascular mortality adjusted for age and sex were 1.89 (1.17-3.00), 1.73 (1.12-2.66) and 1.08 (0.34-3.40) for new diabetes by ADA and WHO criteria and for isolated post-challenge hyperglycaemia, respectively.Conclusions Undiagnosed diabetes was associated with increased risk of all-cause mortality by any criteria but significantly increased cardiovascular disease mortality was only associated with diabetes diagnosed using the fasting glucose criterion. Mortality risks were similar in this population using either ADA or WHO criteria for diagnosis of diabetes.",
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AU - Lee, Amanda Jane

AU - Fowkes, F. G. R.

PY - 2005

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N2 - Aims To compare risk of all-cause and cardiovascular mortality associated with different criteria for undiagnosed diabetes and glucose tolerance.Methods A population-based cohort of 758 men and 738 women of 55-74 years of age who had an oral glucose tolerance test or known diabetes at baseline were followed up until death or for 15 years. Mortality outcomes were compared by baseline diabetes status using people with normal glucose tolerance (i.e. those without diabetes, impaired fasting glucose or impaired glucose tolerance) as the reference group.Results Prevalence of undiagnosed diabetes using World Health Organization (WHO) criteria (fasting glucose of >= 7.0 mmol/l and/or a 2-h post-challenge glucose of >= 11.1 mmol/l) was 6.6%, of which 81% was associated with fasting glucose >= 7.0 mmol/l and 19% was associated with isolated post-challenge hyperglycaemia. Hazard ratios (95% CI) for all-cause mortality adjusted for age and sex were 1.51 (1.09-2.08) for new diabetes by the American Diabetes Association (ADA) criterion (fasting glucose of >= 7.0 mmol/l regardless of post-challenge glucose), 1.60 (1.20-2.13) for new diabetes by WHO criteria and 1.98 (1.14-3.44) for isolated post-challenge hyperglycaemia. Hazard ratios (95% CI) for cardiovascular mortality adjusted for age and sex were 1.89 (1.17-3.00), 1.73 (1.12-2.66) and 1.08 (0.34-3.40) for new diabetes by ADA and WHO criteria and for isolated post-challenge hyperglycaemia, respectively.Conclusions Undiagnosed diabetes was associated with increased risk of all-cause mortality by any criteria but significantly increased cardiovascular disease mortality was only associated with diabetes diagnosed using the fasting glucose criterion. Mortality risks were similar in this population using either ADA or WHO criteria for diagnosis of diabetes.

AB - Aims To compare risk of all-cause and cardiovascular mortality associated with different criteria for undiagnosed diabetes and glucose tolerance.Methods A population-based cohort of 758 men and 738 women of 55-74 years of age who had an oral glucose tolerance test or known diabetes at baseline were followed up until death or for 15 years. Mortality outcomes were compared by baseline diabetes status using people with normal glucose tolerance (i.e. those without diabetes, impaired fasting glucose or impaired glucose tolerance) as the reference group.Results Prevalence of undiagnosed diabetes using World Health Organization (WHO) criteria (fasting glucose of >= 7.0 mmol/l and/or a 2-h post-challenge glucose of >= 11.1 mmol/l) was 6.6%, of which 81% was associated with fasting glucose >= 7.0 mmol/l and 19% was associated with isolated post-challenge hyperglycaemia. Hazard ratios (95% CI) for all-cause mortality adjusted for age and sex were 1.51 (1.09-2.08) for new diabetes by the American Diabetes Association (ADA) criterion (fasting glucose of >= 7.0 mmol/l regardless of post-challenge glucose), 1.60 (1.20-2.13) for new diabetes by WHO criteria and 1.98 (1.14-3.44) for isolated post-challenge hyperglycaemia. Hazard ratios (95% CI) for cardiovascular mortality adjusted for age and sex were 1.89 (1.17-3.00), 1.73 (1.12-2.66) and 1.08 (0.34-3.40) for new diabetes by ADA and WHO criteria and for isolated post-challenge hyperglycaemia, respectively.Conclusions Undiagnosed diabetes was associated with increased risk of all-cause mortality by any criteria but significantly increased cardiovascular disease mortality was only associated with diabetes diagnosed using the fasting glucose criterion. Mortality risks were similar in this population using either ADA or WHO criteria for diagnosis of diabetes.

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KW - DIAGNOSTIC-CRITERIA

KW - GENERAL-POPULATION

KW - HIGH PREVALENCE

KW - MELLITUS

KW - HYPERGLYCEMIA

KW - HISTORY

KW - ADULTS

KW - HEALTH

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DO - 10.1111/j.1464-5491.2004.01433.x

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JO - Diabetic Medicine

JF - Diabetic Medicine

SN - 0742-3071

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