scholarly journals Tingkat Risiko Kejadian Kardiovaskular pada Penyandang Diabetes Melitus Tipe 2

2020 ◽  
Vol 4 (3) ◽  
pp. 182
Author(s):  
Fiska Nur Aini ◽  
Anggi Lukman Wicaksana ◽  
Heny Suseani Pangastuti
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
Risk Prediction ◽  
Cardiovascular Event ◽  
Low Risk ◽  
Risk Level ◽  
Moderate Risk ◽  
Cross Sectional ◽  
Diabetes Melitus

ABSTRAKIndividu dengan diabetes melitus tipe 2 memiliki risiko dua hingga tiga kali lipat terjadinya risiko kejadian kardiovaskular, yaitu serangan jantung atau stroke. Organisasi kesehatan dunia dan masyarakat international hipertensi mengembangkan alat untuk memprediksi tingkat risiko kejadian kardiovaskular dalam kurun waktu sepuluh tahun yang akan datang. Tujuan: Penelitian bertujuan untuk mengetahui tingkatan risiko kardiovaskular pada penyandang diabetes tipe 2 dalam sepuluh tahun mendatang di Yogyakarta. Metode: Penelitian cross-sectional dilakukan di Puskesmas Depok, Yogyakarta dengan menggunakan teknik proportional sampling pada tiga Puskesmas Depok. Responden penelitian yaitu pasien terdiagnosis diabetes tipe 2, berusia 40-79 tahun, dan tidak memiliki komplikasi atau penyakit lain. Instrumen yang digunakan yaitu WHO/ISH risk prediction charts wilayah Indonesia (SEAR B) untuk menilai tingkatan risiko kejadian kardiovaskular. Data diklasifikasikan berdasarkan tingkat risiko kejadian kardiovaskuler yang dimiliki. Data dianalisis secara univariat. Hasil: Sejumlah 66 responden terlibat dengan mayoritas responden adalah perempuan, tidak bekerja, menikah dan rerata usia 61,02 ± 8,86. Tingkat risiko kejadian kardiovaskular penyandang diabetes tipe 2 di Puskesmas Depok, Yogyakarta dalam kurun waktu sepuluh tahun mendatang yaitu risiko rendah 56,1%; risiko sedang 30,3%; risiko tinggi 9,1%; dan risiko sangat tinggi 4,5%. Lebih dari separuh responden memiliki risiko rendah (<10%) terkena serangan jantung atau stroke dalam waktu sepuluh tahun mendatang. Selain itu, satu dari tiga responden memiliki risiko sedang (10-20%) terjadi serangan jantung atau stroke. Kesimpulan: Separuh dari responden penyandang diabetes memiliki risiko non-fatal kejadian kardiovaskular.Kata Kunci: diabetes tipe 2, penyakit kardiovaskular, insidenRisk Level of Cardiovascular Event Among Type 2 Diabetes Mellitus ABSTRACTIndividuals with type 2 diabetes have two to three times risk of cardiovascular event, as heart and stroke attack. World Health Organization and International Society of Hypertension had developed a prediction method of the risk level of cardiovascular event for the following ten years. Objective: This study aimed to identify the risk level of cardiovascular event over the next ten years on people with type 2 diabetes in Yogyakarta. Method: The study used a cross-sectional design in three Public Health Centers Depok, Yogyakarta using proportional sampling technique. The respondents were patients diagnosed with type 2 diabetes, age of 40-79 years, and no comorbidity. The WHO/ISH risk prediction charts for diabetes population in Indonesian (SEAR B) was used to assess the risk level of cardiovascular event. Data was analyzed with univariae analysis. Results: A total of 66 respondents were recruited after reviewing eligibility criteria. The majority of the respondents were women, unemployed, married, and the average age was 61.02 ± 8.86. The risk levels of cardiovascular event among participants in the next ten years were gradually low risk (56.1%); moderate risk (30.3%); high risk (9.1%); and very high risk (4.5%). More than a half of participants had low risk or less than 10% for being cardiovascular event in the following ten years. Furthermore, one third of participants had moderate risk or 10-20% developing cardiac arrest or stroke attack. Conclusion: A half of diabetes participants had non-fatal risk of cardiovascular event.Keywords: type 2 diabetes, cardiovascular disease, incidence

scholarly journals Assessment of Risk of Type 2 Diabetes Among Adults of Banepa Municipality, Nepal: Community Based Cross-Sectional Study

2020 ◽  
Vol 8 (1) ◽  
pp. 31-36
Author(s):  
Sailendra Thapa ◽  
Pratigya Kayastha ◽  
Durga Khadka Mishra
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
Risk Group ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Moderate Risk ◽  
Community Based ◽  
Cross Sectional ◽  
Family History Of Diabetes

Introduction: The prevalence of type 2 diabetes has been escalating worldwide, including low- and middle-income countries such as Nepal. Early detection of individuals at risk is of the utmost importance to prevent the escalating condition. This study used a simple, cost-effective screening tool known as the Indian Diabetes Risk Score (IDRS) in order to assess the proportion of risk groups and factors associated with it among the residents of Banepa municipality, a semi-urban area of central Nepal. Methods: A community-based cross-sectional study was conducted among 245 adults of Banepa municipality. Face to face interviews were conducted to collect the information through a pretested, semi-structured questionnaire. IDRS was used to identify the risk group for developing type 2 diabetes. Data were entered in Microsoft Excel 2010 and exported to SPSS v.11.5 for further analysis. Results: The proportion of people with high risk, moderate risk and low risk was 31%, 51.4% and 17.6%, respectively for developing type 2 diabetes. The analysis showed age (P < 0.01), education (P = 0.05), marital status (P = 0.01), body mass index (BMI) (P < 0.01), waist circumference (P < 0.01), physical activities (P < 0.01) and family history of diabetes (P < 0.04) were significantly associated with risk of type 2 diabetes. Conclusion: Nearly one-third of the study participants were in high-risk group and half of them were at moderate risk. This increasing trend of risk requires an urgent application of preventive measures through lifestyle modification.

scholarly journals PromarkerD Predicts Renal Function Decline in Type 2 Diabetes in the Canagliflozin Cardiovascular Assessment Study (CANVAS)

2020 ◽  
Vol 9 (10) ◽  
pp. 3212
Author(s):  
Kirsten E. Peters ◽  
Jialin Xu ◽  
Scott D. Bringans ◽  
Wendy A. Davis ◽  
Timothy M.E. Davis ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Renal Function ◽  
High Risk ◽  
Low Risk ◽  
Moderate Risk ◽  
Renal Function Decline ◽  
Assessment Study ◽  
Cardiovascular Assessment ◽  
Egfr Decline

The ability of current tests to predict chronic kidney disease (CKD) complicating diabetes is limited. This study investigated the prognostic utility of a novel blood test, PromarkerD, for predicting future renal function decline in individuals with type 2 diabetes from the CANagliflozin CardioVascular Assessment Study (CANVAS). PromarkerD scores were measured at baseline in 3568 CANVAS participants (n = 1195 placebo arm, n = 2373 canagliflozin arm) and used to predict incident CKD (estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2 during follow-up in those above this threshold at baseline) and eGFR decline ≥30% during the 4 years from randomization. Biomarker concentrations (apolipoprotein A-IV (apoA4), CD5 antigen-like (CD5L/AIM) and insulin-like growth factor-binding protein 3 (IGFBP3) measured by mass spectrometry were combined with clinical data (age, serum high-density lipoprotein (HDL)-cholesterol, eGFR) using a previously defined algorithm to provide PromarkerD scores categorized as low-, moderate- or high-risk. The participants (mean age 63 years, 33% females) had a median PromarkerD score of 2.9%, with 70.5% categorized as low-risk, 13.6% as moderate-risk and 15.9% as high-risk for developing incident CKD. After adjusting for treatment, baseline PromarkerD moderate-risk and high-risk scores were increasingly prognostic for incident CKD (odds ratio 5.29 and 13.52 versus low-risk, respectively; both p < 0.001). Analysis of the PromarkerD test system in CANVAS shows the test can predict clinically significant incident CKD in this multi-center clinical study but had limited utility for predicting eGFR decline ≥30%.

scholarly journals Study on prediction of type 2 diabetes mellitus in undergraduate MBBS students: a cross-section study in a tertiary health center, Kolkata

2017 ◽  
Vol 6 (1) ◽  
pp. 184
Author(s):  
Murari M. Mandal ◽  
Shobhit Garg ◽  
R. N. Mishra ◽  
Swanya P. Maharana
Keyword(s):  
Type 2 Diabetes ◽  
Screening Tool ◽  
Risk Group ◽  
Cost Effective ◽  
High Risk Group ◽  
Hip Circumference ◽  
Moderate Risk ◽  
Cross Sectional ◽  
Random Blood Sugar

Background: Diabetes, is now a leading cause of morbidity and mortality worldwide. Prevalence of type-2 diabetes in children and adolescents is rapidly increasing worldwide. Adolescence and early youth period has pivotal importance for young people with diabetes risk when they usually start learning about how to take responsibility. With this background, present study was done to find out the proportion of various risk factors and future risk of developing diabetes among MBBS undergraduates in Kolkata.Methods: This study was a cross-sectional institution based study done from 1st June to 18th June 2017. Data was collected by interviewing each respondent with the help of structured pre-designed pre-tested schedule, after which clinical examination for height, weight, waist and hip circumference, blood pressure and RBS were done. Out of 150 undergraduates, 130 agreed to participate. Data was analysed with R software.Results: Mean age of the students was 20.45years. 48.5% of them were either overweight or obese. Nearly half of them had waist circumference and waist hip ratio in risk group. Only 65 were normotensive and 7 had high random blood sugar (≥140 mg/dl). 6 students were in high risk group according to both IDRS (≥60) and ADA (≥5) risk score. 66 students were in moderate risk (30-50) group as per IDRS risk score.Conclusions: The simple and cost-effective IDRS could serve as a screening tool health worker to identify at risk individuals at the earliest and enable primary prevention by encouraging these students to modify their life-style.

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>

Comparison of IDRS and ADA Diabetes Risk Assessment Tools Reveals Different Rsk Score in Same Population: A Cross-Sectional Analysis in a Tertiary Care Hospital

2021 ◽  
Vol 5 (1) ◽  
pp. 10-18
Author(s):  
N. Akter ◽  
N.K. Qureshi
Keyword(s):  
Type 2 Diabetes ◽  
Risk Assessment ◽  
High Risk ◽  
Risk Score ◽  
Diabetes Risk ◽  
Assessment Tools ◽  
Cross Sectional ◽  
Risk Assessment Tools ◽  
Predicted Risk

Background: To identify individuals at high risk of developing type2 diabetes (T2DM), use of a validated risk-assessment tool is currently recommended. Nevertheless, recent studies have shown that risk scores that are developed in the same country can lead to different results of an individual. The Objective of study was to reveal whether two different risk-assessment tools predict similar or dissimilar high-risk score in same population. Method: This cross-sectional analytical study was carried upon 336 non-diabetic adults visiting the outpatient department (OPD) of Medicine, MARKS Medical College & Hospital, Bangladesh from October 2018 to March 2019. Woman having previous history of Gestational Diabetes Mellitus (GDM) were also included. Both the Indian Diabetes risk Score (IDRS) and the American Diabetes (ADA) Risk Score questionnaire were used to collect the data on demographic and clinical characteristics, different risk factors of an individual subject, and to calculate predicted risk score for developing T2DM. Results: Among 336 subjects, 53.6% were female. The mean (±SD) age of the study subjects was 38.25±1.12 years. The average IDRS predicted risk score of developing T2DM was more in female subjects than male [p<0.05]. Whereas the ADA predicted increased risk score of developing type 2 diabetes was more in male subjects than female (p<0.05). IDRS categorized 37.2 % of individuals at high risk for developing diabetes; [p=0.10], while the ADA risk tool categorized 20.2% subjects in high risk group; [p<0.001]. Conclusions: The results indicate that risk for developing type 2 diabetes varies considerably according to the scoring system used. To adequately prevent T2DM, risk scoring systems must be validated for each population considered.

Anthropometric measures in risk prediction for type 2 diabetes mellitus? – A cross-sectional study in regular athletes

2021 ◽  
Vol 10 (2) ◽  
pp. 152
Author(s):  
Shatavisa Mukherjee ◽  
ShamboSamrat Samajdar ◽  
SabnamAra Begum ◽  
Sumalya Sen ◽  
SantanuKumar Tripathi
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Risk Prediction ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Anthropometric Measures ◽  
Cross Sectional

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.

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