Thirty-year Trends in Complications in U.S. Adults With Newly Diagnosed Type 2 Diabetes

10.2337/figshare.13308467 ◽

2021 ◽

Author(s):

Michael Fang ◽

Elizabeth Selvin

Keyword(s):

Cardiovascular Disease ◽

Diabetes Diagnosis ◽

Newly Diagnosed ◽

The Past ◽

History Of ◽

Lipid Control ◽

Retinal Microaneurysms ◽

Diagnosed Diabetes ◽

Design And Methods ◽

Newly Diagnosed Diabetes

Objective: To assess the prevalence of and trends in complications among US adults with newly diagnosed diabetes. Research design and methods: We included 1,486 nonpregnant adults (aged≥20 years) with newly diagnosed diabetes (diagnosed within the past 2 years) from the 1988-1994 and 1999-2018 National Health and Nutrition Examination Survey. We estimated trends in albuminuria (albumin-to-creatinine ratio≥30 mg/g), reduced estimated glomerular filtration rate (eGFR<60 ml/min/1.73 m2), retinopathy (any retinal microaneurysms or blot hemorrhages), and self-reported cardiovascular disease (history of congestive heart failure, heart attack, or stroke). Results: From 1988-1994 to 2011-2018, there was a significant decrease in the prevalence of albuminuria (38.9 to 18.7%, p-for-trend<0.001), but no change in the prevalence of reduced eGFR (7.5 to 9.9%, p-for-trend=0.30), retinopathy (1988-1994 to 1999-2008 only; 13.2 to 12.1%, p-for-trend=0.86), or self-reported cardiovascular disease (19.0 to 16.5%, p-for-trend=0.64). There were improvements in glycemic, blood pressure, and lipid control in the population, and these partially explained the decline in albuminuria. Complications were more common at the time of diabetes diagnosis for adults who were older, lower income, less educated, and obese. Conclusion: Over the past three decades, there have been encouraging reductions in albuminuria and risk factor control in adults with newly diagnosed diabetes. However, the overall burden of complications around the time of diagnosis remains high.

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Long term prognostic implication of newly detected abnormal glucose tolerance among patients with stable cardiovascular disease: a population-based study

10.21203/rs.3.rs-21088/v1 ◽

2020 ◽

Author(s):

Maryam Kabootari ◽

Samaneh Asgari ◽

Seyedeh Maryam Ghavam ◽

Fereidoun Azizi ◽

Farzad Hadaegh

Keyword(s):

Cardiovascular Disease ◽

Glucose Tolerance ◽

Plasma Glucose ◽

Population Based ◽

Incident Diabetes ◽

Continuous Variables ◽

Newly Diagnosed ◽

History Of ◽

Diagnosed Diabetes ◽

Newly Diagnosed Diabetes

Abstract Background: To assess the association between fasting plasma glucose (FPG) and 2-h post challenge plasma glucose (2h-PCPG) as continuous or categorical variables with risk of recurrent cardiovascular disease (CVD) and incident diabetes among subjects with history of previous CVD. Methods: In a prospective population-based cohort, a total of 335 Iranians aged ≥30 years, with history of CVD and free of known diabetes were included. Prediabetes was defined as impaired fasting glucose (IFG) according to the criteria of the American Diabetes Association (ADA) [IFG-ADA; FPG: 5.6-6.9 mmol/L], the World Health Organization (WHO) expert group (IFG-WHO; FPG: 6.1-6.9 mmol/L) and impaired glucose tolerance [IGT: 2h-PCPG: 7.8-11.0 mmol/L]. Cox’s proportional hazard models adjusted for traditional risk factors were used to estimate the hazard ratio (HR) with 95% confidence interval (CI) of different glucose intolerance for outcomes of interest. Results: During a median follow-up of 15.8 (IQR, 10.7-16.5) years, 178 CVD (hard event including death, myocardial infarction and stroke=69) events occurred. Regarding FPG, only IFG-ADA was associated with significant higher risk of hard CVD in the fully adjusted model (HR, 1.73, 95% CI: 1.04-2.89). Moreover, newly diagnosed diabetes (FPG≥7 mmol/L) was an independent risk of CVD (2.11: 1.22-3.66). Focusing on 2h-PCPG, subjects with newly diagnosed diabetes (2h-PCPG ≥ 11.1 mmol/L) had moderately increased risk of hard coronary heart disease (2.02:0.91-4.47, P=0.08). The multivariate HRs (95% CI) associated with 1 SD increase in FPG and 2h-PCPG was 1.16 (1.01–1.33) and 1.19 (1.02–1.38) for CVD, respectively. Among population free of diabetes at baseline (n=270), IFG-ADA, IFG-WHO and IGT were significantly associated with incident diabetes in multivariate analysis (all HRs > 4, P< 0.001); significant associations were also found for FPG and 2h-PCPG as continuous variables (all HRs for 1-SD increase > 2, all P < 0.001). Conclusions: Among subjects with stable CVD, both FPG and 2h-PCPG as continuous variables was associated with higher risk of recurrent CVD. However, only IFG-ADA was independent predictor of hard CVD events. Also, newly diagnosed diabetes, using FPG criteria, was associated with a significant risk of CVD. IFG-ADA, IFG-WHO and IGT were all significant predictors of incident diabetes.

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Abstract 17910: Patients with Newly Diagnosed Diabetes Have Comparable Long Term Mortality with Known Diabetics After ST Segment Elevation Myocardial Infarction

Circulation ◽

10.1161/circ.130.suppl_2.17910 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Bhuvnesh Aggarwal ◽

Gautam Shah ◽

Mandeep S Randhawa ◽

A M Lincoff ◽

Stephen G Ellis ◽

...

Keyword(s):

Prior History ◽

Newly Diagnosed ◽

St Segment Elevation ◽

St Segment ◽

History Of ◽

Diagnosed Diabetes ◽

Newly Diagnosed Diabetes ◽

Long Term Mortality

Background: A significant proportion of patients presenting with ST segment elevation myocardial infarction (STEMI) have newly diagnosed diabetes mellitus (DM). Hypothesis: Our aim was to identify patients with previously undiagnosed DM and compare their outcomes to those with known DM and without DM after STEMI. Methods: Consecutive patients undergoing primary PCI for STEMI at our center between Jan 2005 - Dec 2012 were included. Routinely performed admission Glycated hemoglobin (HbA1c) was utilized to identify patients with previously undiagnosed DM (HbA1c ≥ 6.5 and no history of DM or diabetes therapy). Patients were compared for in-hospital and long-term mortality based on follow up data from our institutional PCI registry. Results: 1,734 consecutive patients underwent primary PCI for STEMI and follow up data was available for 1,566 (90%) patients. Mean age was 60 years and 67.3% were males. A quarter of the patients (24.3%, n = 382) had prior history of DM and 8% (n=95) of the remainder had undiagnosed DM. Median follow up was 35 months. Mortality was comparable in patients with known DM and newly diagnosed DM both in hospital (11.2% vs. 12.5%, p=0.87) and at long term follow up (Figure 1, 2). Mortality was significantly worse with both groups when compared with patients with no DM (In-hospital mortality 5.6%; p<0.001 for both groups). Conclusions: One in twelve patients presenting with STEMI have previously undiagnosed DM. Cardiologists have a unique opportunity for identification and initiation of diabetic therapy in this vulnerable population. Patients with newly diagnosed DM have similar short and long-term outcomes when compared with patients with a prior history of DM.

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Insulin Allergy in a 19-Month-Old Boy with Newly Diagnosed Diabetes Mellitus

PEDIATRICS ◽

10.1542/peds.70.1.137 ◽

1982 ◽

Vol 70 (1) ◽

pp. 137-138

Author(s):

Kathleen L. Wishner ◽

Lynda K. Fisher ◽

Dinesh Kumar

Keyword(s):

Diabetes Mellitus ◽

Insulin Therapy ◽

Blood Glucose Concentration ◽

Continuous Treatment ◽

Newly Diagnosed ◽

Insulin Allergy ◽

History Of ◽

Systemic Symptoms ◽

Diagnosed Diabetes ◽

Newly Diagnosed Diabetes

Systemic insulin allergy is rare and usually occurs in adults with diabetes mellitus following reinstitution of insulin therapy.1,2 The present case is unusual in that the systemic symptoms appeared 23 days after initial continuous treatment with insulin in a very young child. CASE REPORT An 18-month-old boy was seen by his pediatrician six weeks after a severe episode of varicella, with a monilial diaper rash and a three-week history of polyuria, polydipsia, polyphagia, and weight loss. The blood glucose concentration was 534 mg/100 ml and serum ketones were present. Diabetes mellitus was diagnosed. He was hospitalized and insulin therapy was instituted without incident; the patient was discharged on a daily mixed dose of regular and isophane (NPH) insulins (single-peak, beef-pork mixture, Eli Lilly & Co).

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Prevalence of Abnormal Glucose Regulation according to Different Diagnostic Criteria in Ischaemic Stroke without a History of Diabetes

BioMed Research International ◽

10.1155/2018/8358724 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Xinmiao Zhang ◽

Qiuyan Shi ◽

Huaguang Zheng ◽

Qian Jia ◽

Xingquan Zhao ◽

...

Keyword(s):

Ischaemic Stroke ◽

Glucose Regulation ◽

Oral Glucose ◽

Haemoglobin A1c ◽

Newly Diagnosed ◽

Stroke Patients ◽

Abnormal Glucose Regulation ◽

History Of ◽

Diagnosed Diabetes ◽

Newly Diagnosed Diabetes

We aimed to investigate the prevalence and distribution of abnormal glucose regulation, including prediabetes and newly diagnosed diabetes, according to different criteria in ischaemic stroke patients without a history of diabetes. Data were derived from a representative cohort across China. Prediabetes was defined as fasting plasma glucose (FPG) 5.6–6.9 mmol/L or 2-hour oral glucose tolerance test (OGTT) 7.8–11.0 mmol/L or haemoglobin A1c (HbA1c) 5.7–6.4%. Newly diagnosed diabetes was defined as FPG ≥ 7.0 mmol/L, 2 h OGTT ≥ 11.1 mmol/L or HbA1c ≥ 6.5%. Among 1251 ischaemic stroke patients, 471 (37.5%) were detected as prediabetes and 539 (43.1%) were detected as newly diagnosed diabetes. Prediabetes was present in 118 (9.4%), 290 (23.2%) and 314 (25.1%) stroke patients, and newly diagnosed diabetes was present in 138 (11.0%), 370 (29.6%), and 365 (29.2%) stroke patients, based on FPG, 2 h OGTT, and HbA1c criteria, respectively. Dependency on FPG alone would have missed 74.9% of patients in the prediabetes range and 74.4% of patients in the diabetes range. Our study demonstrated a high prevalence of prediabetes and diabetes in ischaemic stroke patients without a history of diabetes. OGTT and HbA1c helped detect the majority of prediabetes and newly diagnosed diabetes in ischaemic stroke patients.

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