scholarly journals Incident type 2 diabetes and risk of fracture: a comparative cohort analysis using UK primary care records

2020 ◽  
Author(s):  
Gabrielle S Davie ◽  
Kingshuk Pal ◽  
Elizabeth Orton ◽  
Edward G Tyrrell ◽  
Irene Petersen
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Lifestyle Changes ◽  
Health Improvement ◽  
Prevalence Rates ◽  
Risk Of Fracture ◽  
Incident Type ◽  
Increased Risk ◽  
Incident Type 2 Diabetes

<b>Objective </b>To estimate risk of fracture in men and women with recent diagnosis of type 2 diabetes compared to individuals without diabetes. <p><b>Research Design and Methods<strong> </strong></b>In this cohort study we used routinely-collected UK primary care data from The Health Improvement Network. In adults (>35 years) diagnosed with type 2 diabetes between 2004-2013 fractures sustained until 2019 were identified and compared to fractures sustained in individuals without diabetes. Multivariable models estimated time to first fracture following diagnosis of diabetes. Annual prevalence rates included at least one fracture in a given year. <strong></strong></p> <p><strong>Results </strong>Among 174,244 individuals with incident type 2 diabetes and 747,290 without diabetes, there was no increased risk of fracture among males with diabetes (adjusted hazards ratio (aHR) 0.97 (95%CI 0.94, 1.00)) and a small reduced risk among females (aHR 0.94, (95%CI 0.92, 0.96)). In those aged 85 years and over those in the diabetes cohort were at significantly lower risk of incident fracture (Males: aHR 0.85, 95%CI 0.71, 1.00; Females: aHR 0.85, 95%CI 0.78, 0.94). For those in the most deprived areas, aHRs were 0.90 (95%CI 0.83, 0.98) for males and 0.91 (95%CI 0.85, 0.97) for females. Annual fracture prevalence rates, by sex, were similar for those with and without type 2 diabetes.</p> <p><strong>Conclusion We found </strong>no evidence to suggest a higher risk of fracture following diagnosis of type 2 diabetes. After a diagnosis of type 2 diabetes individuals should be encouraged to make positive lifestyle changes, including undertaking weight-bearing physical activities that improve bone health.</p>

scholarly journals Incident type 2 diabetes and risk of fracture: a comparative cohort analysis using UK primary care records

2020 ◽  
Author(s):  
Gabrielle S Davie ◽  
Kingshuk Pal ◽  
Elizabeth Orton ◽  
Edward G Tyrrell ◽  
Irene Petersen
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Lifestyle Changes ◽  
Health Improvement ◽  
Prevalence Rates ◽  
Risk Of Fracture ◽  
Incident Type ◽  
Increased Risk ◽  
Incident Type 2 Diabetes

<b>Objective </b>To estimate risk of fracture in men and women with recent diagnosis of type 2 diabetes compared to individuals without diabetes. <p><b>Research Design and Methods<strong> </strong></b>In this cohort study we used routinely-collected UK primary care data from The Health Improvement Network. In adults (>35 years) diagnosed with type 2 diabetes between 2004-2013 fractures sustained until 2019 were identified and compared to fractures sustained in individuals without diabetes. Multivariable models estimated time to first fracture following diagnosis of diabetes. Annual prevalence rates included at least one fracture in a given year. <strong></strong></p> <p><strong>Results </strong>Among 174,244 individuals with incident type 2 diabetes and 747,290 without diabetes, there was no increased risk of fracture among males with diabetes (adjusted hazards ratio (aHR) 0.97 (95%CI 0.94, 1.00)) and a small reduced risk among females (aHR 0.94, (95%CI 0.92, 0.96)). In those aged 85 years and over those in the diabetes cohort were at significantly lower risk of incident fracture (Males: aHR 0.85, 95%CI 0.71, 1.00; Females: aHR 0.85, 95%CI 0.78, 0.94). For those in the most deprived areas, aHRs were 0.90 (95%CI 0.83, 0.98) for males and 0.91 (95%CI 0.85, 0.97) for females. Annual fracture prevalence rates, by sex, were similar for those with and without type 2 diabetes.</p> <p><strong>Conclusion We found </strong>no evidence to suggest a higher risk of fracture following diagnosis of type 2 diabetes. After a diagnosis of type 2 diabetes individuals should be encouraged to make positive lifestyle changes, including undertaking weight-bearing physical activities that improve bone health.</p>

scholarly journals Incident Type 2 Diabetes and Risk of Fracture: A Comparative Cohort Analysis Using U.K. Primary Care Records

Diabetes Care ◽  
2020 ◽  
Vol 44 (1) ◽  
pp. 58-66
Author(s):  
Gabrielle S. Davie ◽  
Kingshuk Pal ◽  
Elizabeth Orton ◽  
Edward G. Tyrrell ◽  
Irene Petersen
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Cohort Analysis ◽  
Risk Of Fracture ◽  
Incident Type ◽  
Incident Type 2 Diabetes

Abstract MP037: Plasma Organochlorine Concentration and Risk of Diabetes: the Nurses' Health Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Hongyu Wu ◽  
Kimberly A Bertrand ◽  
Anna L Choi ◽  
Frank B Hu ◽  
Francine Laden ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Polychlorinated Biphenyl ◽  
Plasma Concentrations ◽  
Diabetes Risk ◽  
Health Study ◽  
Blood Draw ◽  
Incident Type ◽  
Increased Risk ◽  
Incident Type 2 Diabetes

Background: Animal experiments have suggested that exposure to persistent organic pollutants (POPs) may lead to increased risk of type 2 diabetes. Although recent human studies supported this hypothesis, evidence from prospective investigations is sparse. Objective: To examine the associations of plasma POP concentrations with risk of incident type 2 diabetes in a prospective setting among US women. Methods: Study population was comprised of participants from two independent nested case-control studies in the Nurses’ Health Study, in which major polychlorinated biphenyl (PCB 118, 138, 153, and 180), p-p'- dichlorodiphenyldichloroethylene (DDE), dichlorodiphenyltrichloroethane (DDT), and hexachlorobenzene (HCB) were measured. A non-parametric approach was used to derive standardized scores for plasma concentrations of lipid-adjusted POPs within each study to minimize between-study variation of the POP measurements. Risk of incident type 2 diabetes during the follow-up period (1990-2008) across the tertiles of the scores was examined. Results: Of 1,120 participants, we identified 48 incident type 2 diabetes cases. After adjusting for covariates assessed at blood draw in 1990, including smoking status, body mass index, and total fish intake, plasma HCB concentration was positively associated with type 2 diabetes risk: odds ratio (OR) (95% confidence interval [CI]) was 2.77 (1.17, 6.55, P for trend =0.022) comparing the highest vs. lowest tertile. Other POPs were not significantly associated with diabetes: the ORs (95% CI) were 1.10 (0.51, 2.34, P for trend =0.81) for p-p'-DDE, 0.93 (0.44, 1.95, P for trend =0.86) for DDT, and 0.88 (0.39, 1.97, P for trend =0.76) for sum of the 4 major PCBs, comparing the extreme tertiles. Conclusion: The significant association of plasma HCB concentration with diabetes risk supports a role of POP exposure in the etiology of type 2 diabetes. More prospective data are warranted to confirm these findings.

scholarly journals The Risk of Incident Type 2 Diabetes in a Korean Metabolically Healthy Obese Population: The Role of Systemic Inflammation

2015 ◽  
Vol 100 (3) ◽  
pp. 934-941 ◽  
Author(s):  
Chang Hee Jung ◽  
Min Jung Lee ◽  
Yu Mi Kang ◽  
Jung Eun Jang ◽  
Jaechan Leem ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Systemic Inflammation ◽  
Incident Type ◽  
Metabolically Healthy Obese ◽  
Increased Risk ◽  
Incident Type 2 Diabetes ◽  
Healthy Obese ◽  
Metabolically Healthy ◽  
Inflammation Group

Abstract Objective: This study sought to investigate whether the metabolically healthy obese (MHO) phenotype is associated with an increased risk of incident type 2 diabetes in a Korean population and, if so, whether systemic inflammation affects this risk in MHO individuals. Design and Methods: The study population comprised 36 135 Koreans without type 2 diabetes. Participants were stratified by body mass index (cutoff value, 25.0 kg/m2) and metabolic health state (assessed using Adult Treatment Panel-III criteria). High-sensitive C-reactive protein (hsCRP) was used as a surrogate marker of systemic inflammation. Subjects were classified into low (ie, hsCRP &lt; 0.5 mg/L) and high (ie, hsCRP ≥ 0.5 mg/L) systemic inflammation groups. Results: During a median followup of 36.5 months (range, 4.8–81.7 mo), 635 of the 36 135 individuals (1.8%) developed type 2 diabetes. The MHO group had a significantly higher risk of incident type 2 diabetes (multivariate-adjusted hazard ratio [HR], 1.57; 95% confidence interval [CI], 1.16–2.11) than the metabolically healthy nonobese (MHNO) group. However, the risk of the MHO group varied according to the degree of systemic inflammation. Compared with the MHNO/low systemic inflammation group, the risk of type 2 diabetes in the MHO/low systemic inflammation group was not significantly elevated (multivariate-adjusted HR, 1.61; 95% CI, 0.77–3.34). However, the MHO/high systemic inflammation group had an elevated risk of incident type 2 diabetes (multivariate-adjusted HR, 3.73; 95% CI 2.36–5.88). Conclusions: MHO subjects show a substantially higher risk of incident type 2 diabetes than MHNO subjects. The level of systemic inflammation partially explains this increased risk.

scholarly journals Serum creatinine levels and risk of incident type 2 diabetes mellitus or dysglycemia in middle-aged Japanese men: a retrospective cohort study

2018 ◽  
Vol 6 (1) ◽  
pp. e000492 ◽  
Author(s):  
Mamoru Takeuchi ◽  
Hironori Imano ◽  
Isao Muraki ◽  
Yuji Shimizu ◽  
Mina Hayama-Terada ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Serum Creatinine ◽  
Incident Type ◽  
Increased Risk ◽  
Incident Type 2 Diabetes ◽  
Fasting Plasma Glucose Concentration

ObjectiveTo assess the association between low serum creatinine levels and an increased risk of type 2 diabetes mellitus and dysglycemia.Research design and methodsWe conducted a retrospective cohort study of 3313 Japanese male workers aged 30–55 years, who underwent annual health check-ups during 2001–2008 and showed no type 2 diabetes mellitus, and underwent follow-up examinations until March 2013. Dysglycemia was defined as a fasting plasma glucose concentration of ≥110 mg/dL (6.1 mmol/L), or a non-fasting plasma glucose concentration of ≥140 mg/dL (7.8 mmol/L). A Cox proportional model was used to calculate HRs and 95% CIs for developing type 2 diabetes mellitus or dysglycemia.ResultsDuring the median 6.7-year follow-up, there were 207 cases of incident type 2 diabetes mellitus and 596 cases of incident dysglycemia, including 115 cases of type 2 diabetes mellitus among the subjects with normal glucose concentrations at baseline. After adjustment for age, body mass index and known diabetes risk factors, the multivariable HR of type 2 diabetes mellitus for the lowest category of serum creatinine (<0.7 mg/dL) vs the highest category (0.9–1.1 mg/dL) was 1.9 (95% CI 1.2 to 2.9; P for trend 0.03). The multivariable HRs of dysglycemia for the lowest category of serum creatinine versus the highest category was 1.5 (95% CI 1.1 to 1.9; P for trend 0.01).ConclusionsLow serum creatinine levels were associated with an increased risk of type 2 diabetes mellitus and dysglycemia.

scholarly journals Associations of ultra-processed food and its consumption patterns with incident type 2 diabetes

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Duan ◽  
P C Vinke ◽  
G J Navis ◽  
E Corpeleijn ◽  
L H Dekker
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Risk ◽  
Consumption Patterns ◽  
Processed Foods ◽  
Inverse Association ◽  
Processed Food ◽  
Incident Type ◽  
Increased Risk ◽  
Incident Type 2 Diabetes

Abstract Background To study the associations of the consumption of ultra-processed food (UPF) and its underlying habitual consumption patterns with incident type 2 diabetes (T2D) in a large population-based cohort. Methods In 70 421 participants (35-70 years, 58.6% women) from the Lifelines cohort study, dietary intake was assessed with a food frequency questionnaire. Principal component analysis (PCA) was performed to derive UPF consumption patterns. UPF was related to incident diabetes with adjustments for confounders, including overall diet quality. Results During a median follow-up of 41 months, the intake of UPF was associated with higher risk of type 2 diabetes (1128 cases, OR for a 10% increment in UPF intake 1.33 [95% CI 1.26, 1.41]), and remained significant after adjustment for confounders. PCA revealed four habitual UPF consumption patterns. A pattern high in cold savory snacks (OR 1.16 [95% CI 1.09, 1.22]) and a pattern high in warm savory snacks (OR 1.15 [95% CI 1.08, 1.21]) were associated with an increased diabetes risk; a pattern high in traditional Dutch cuisine was not associated with diabetes risk (OR 1.05 [95% CI 0.97, 1.14]); while a pattern high in sweet snacks and pastries was inversely associated with diabetes risk (OR 0.82 [95% CI 0.76, 0.89]). There was a clear inverse association between diabetes risk at baseline and the sweet snacks and pastries pattern (β = -0.104 [95% CI -0.113, -0.094]). Conclusions A higher consumption of UPF was associated with higher risk of type 2 diabetes. For consumption patterns, this association was most pronounced for the patterns that were high in savory snacks. Our findings emphasize that in addition to promoting the consumption of healthy food products, discouraging the consumption of UPF, specifically savory snacks, should be considered as part of future diabetes prevention strategies. Key messages Ultra-processed foods intake was associated with increased risk of type 2 diabetes. Consumption patterns of ultra-processed foods should be the focus for future policies.

scholarly journals High intakes of protein and processed meat associate with increased incidence of type 2 diabetes

2012 ◽  
Vol 109 (6) ◽  
pp. 1143-1153 ◽  
Author(s):  
Ulrika Ericson ◽  
Emily Sonestedt ◽  
Bo Gullberg ◽  
Sophie Hellstrand ◽  
George Hindy ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Protein Intake ◽  
Population Based ◽  
High Protein ◽  
Processed Meat ◽  
High Protein Intake ◽  
Incident Type ◽  
Increased Risk ◽  
Incident Type 2 Diabetes

Diets high in protein have shown positive effects on short-term weight reduction and glycaemic control. However, the understanding of how dietary macronutrient composition relates to long-term risk of type 2 diabetes is limited. The aim of the present study was to examine intakes of macronutrients, fibre and protein sources in relation to incident type 2 diabetes. In total, 27 140 individuals, aged 45–74 years, from the population-based Malmö Diet and Cancer cohort, were included. Dietary data were collected with a modified diet history method, including registration of cooked meals. During 12 years of follow-up, 1709 incident type 2 diabetes cases were identified. High protein intake was associated with increased risk of type 2 diabetes (hazard ratio (HR) 1·27 for highest compared with lowest quintile; 95 % CI 1·08, 1·49; P for trend = 0·01). When protein consumption increased by 5 % of energy at the expense of carbohydrates (HR 1·20; 95 % CI 1·09, 1·33) or fat (HR 1·21; 95 % CI 1·09, 1·33), increased diabetes risk was observed. Intakes in the highest quintiles of processed meat (HR 1·16; 95 % CI 1·00, 1·36; P for trend = 0·01) and eggs (HR 1·21; 95 % CI 1·04, 1·41; P for trend = 0·02) were associated with increased risk. Intake of fibre-rich bread and cereals was inversely associated with type 2 diabetes (HR 0·84; 95 % CI 0·73, 0·98; P for trend = 0·004). In conclusion, results from the present large population-based prospective study indicate that high protein intake is associated with increased risk of type 2 diabetes. Replacing protein with carbohydrates may be favourable, especially if fibre-rich breads and cereals are chosen as carbohydrate sources.

scholarly journals Egg consumption and risk of incident type 2 diabetes: a dose–response meta-analysis of prospective cohort studies

2016 ◽  
Vol 115 (12) ◽  
pp. 2212-2218 ◽  
Author(s):  
Martha Tamez ◽  
Jyrki K. Virtanen ◽  
Martin Lajous
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Studies ◽  
Dose Response ◽  
Meta Analysis ◽  
Diabetes Risk ◽  
Incident Type ◽  
Egg Consumption ◽  
Increased Risk ◽  
Incident Type 2 Diabetes

AbstractExperimental data suggest that egg intake could have a beneficial impact on several risk factors for type 2 diabetes. In contrast, some recent epidemiological studies have concluded that egg consumption may increase diabetes risk. We performed a dose–response meta-analysis of prospective cohorts on the relation of egg consumption with incident type 2 diabetes. We searched for cohort studies that assessed egg consumption and diabetes risk up to June 2015. We identified 416 articles and extracted data independently and in duplicate from ten eligible studies. We used random-effects generalised least squares models for pooled dose–response estimation based on thirteen estimates. Our study included 251 213 individuals and 12 156 incident type 2 diabetes cases. Egg intake was associated with incident type 2 diabetes (risk ratio (RR)/egg per d 1·13; 95 % CI 1·04, 1·22). We identified study location as a major source of heterogeneity. For studies conducted in the USA, we observed a stronger association (RR 1·47; 95 % CI 1·32, 1·64), whereas results were null for studies conducted elsewhere. Studies considered to be of high quality yielded null findings (RR 0·94; 95 % CI 0·74, 1·19). The association of egg intake with increased risk of incident type 2 diabetes may be restricted to US cohort studies. There are limited data to support a biological mechanism that could underlie this association; thus, the possibility that these results may be due to residual confounding by dietary behaviours restricted to certain populations cannot be excluded.

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