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  • American Diabetes Association  (4)
  • 2020-2024  (4)
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  • American Diabetes Association  (4)
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  • 2020-2024  (4)
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  • 1
    Online Resource
    Online Resource
    1476-P: Progression to Type 2 Diabetes from Normal or Impaired Fasting Glucose
    American Diabetes Association ; 2020
    In:  Diabetes Vol. 69, No. Supplement_1 ( 2020-06-01)
    Details
    In: Diabetes, American Diabetes Association, Vol. 69, No. Supplement_1 ( 2020-06-01)
    Abstract: The interaction of anthropometric variables with fasting blood glucose on progression from normal fasting glucose to overt diabetes (DM), is uncertain. In the Rochester Epidemiology Project (MN, USA), we identified 44,992 individuals with ≥ 2 fasting plasma glucose (FPG) tests from 2005-17, after excluding people who met criteria for DM (FPG & gt; 125mg/dL) on/before their first FPG. The cohort was 58% female, had an age range of 18-65 yrs (44 ± 10, Mean ± SD) and BMI of 29 ± 7 kg/m2. Subjects who did not develop DM were censored at their last FPG value on/before Dec 31, 2017. Those who developed DM were assigned an event date as the first diagnostic value. Over a median follow-up of 7 yrs, 3888 (8.6%) developed DM. The Kaplan-Meier 10-year cumulative risk of incident DM was 12.8% (CI 12.4%-13.3%). As expected, multivariable Cox modeling identified elevated initial FPG [100-109mg/dL (HR 2.0; 1.9-2.2); 110-125mg/dL (HR 5.8; 5.4-6.3)] as conferring increased risk. Other independent risks were male sex (HR 1.30; 95% CI 1.22-1.38) and abnormal BMI [ & lt;18 kg/m2 (2.67; 1.96-3.63), 25-29.9 kg/m2 (1.37; 1.23-1.52), 30-34.9 kg/m2 (2.15; 1.92-2.39), ≥ 35 kg/m2 (3.59; 3.23-3.99)]. A very strong, nonlinear, age effect was also noted, with a fitted hazard ratio for age 60 versus 20 of 2.65. In this large cohort, male sex, age and abnormal category of BMI (including underweight) are associated with increased risk of progression to DM and additive to baseline FPG. Disclosure A.M. Egan: None. C. Wood-Wentz: None. K.R. Bailey: None. A. Vella: Advisory Panel; Self; vTv Therapeutics, Zealand Pharma A/S. Research Support; Self; Novo Nordisk A/S, Xeris Pharmaceuticals, Inc.
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    URL: Article
    DOI: 10.2337/db20-1476-P
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2020
    detail.hit.zdb_id: 1501252-9
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    Online Resource
  • 2
    Online Resource
    Online Resource
    71-OR: County Social Vulnerability and Disparities in Incidence of Diagnosed Diabetes
    American Diabetes Association ; 2022
    In:  Diabetes Vol. 71, No. Supplement_1 ( 2022-06-01)
    Details
    In: Diabetes, American Diabetes Association, Vol. 71, No. Supplement_1 ( 2022-06-01)
    Abstract: Individual sociodemographic factors determine risk of diabetes. However, the association of a multidimensional social vulnerability index (SVI) and incident diabetes is unknown. We used CDC data on incidence of diagnosed diabetes, 2011-2018, in adults ≥20 years and defined county social vulnerability using two CDC indices: SVI minority health (SVI-MH; includes 6 dimensions) and SVI (includes 4 dimensions) . Trends in the annual age-adjusted incident diabetes rate per 1000 adults (AADR) were derived from weighted least squares regression. Year and SVI-MH/SVI were fitted nonlinearly with spline functions to test 2018 vs. 20fold-changes in AADR for levels of SVI-MH/SVI. Expressed by SVI-MH percentiles, low (10th) , median (50th) , and high (90th) vulnerability corresponded to overall AADR of 6.8, 8.5, and 10.5, respectively. In all years, counties with higher vulnerability (ie, higher SVI-MH) had significantly higher AADR. In 2018, compared to 2011, counties with high vulnerability showed a small AADR fold-decrease (0.97 [0.95-0.98] ; P & lt;.001) . The AADR fold-decrease was larger in counties with median vulnerability (0.92 [0.90-0.94]; P & lt;.001) . In counties with low vulnerability, there was no AADR fold-change (P=.35) . Results for AADR analyzed by SVI were generally similar. In summary, US counties with high SVI-MH/SVI had high AADR, and these indices could inform multidimensional interventions for diabetes prevention. Disclosure K.R. Bailey: None. A. Vella: Advisory Panel; Crinetics Pharmaceuticals, Inc., Rezolute, Inc., vTv Therapeutics, Zealand Pharma A/S. Other Relationship; Novo Nordisk. M.M. Mielke: Consultant; Biogen, LabCorp. Funding National Institute on Minority Health and Health Disparities (NIH K23 MD016230)
    Type of Medium: Online Resource
    ISSN: 0012-1797
    URL: Article
    DOI: 10.2337/db22-71-OR
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2022
    detail.hit.zdb_id: 1501252-9
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  • 3
    Online Resource
    Online Resource
    1202-P: Disparities in Incidence of Diagnosed Diabetes in Rural United States, 2011–2018
    American Diabetes Association ; 2022
    In:  Diabetes Vol. 71, No. Supplement_1 ( 2022-06-01)
    Details
    In: Diabetes, American Diabetes Association, Vol. 71, No. Supplement_1 ( 2022-06-01)
    Abstract: US rural, compared to non-rural, populations have diabetes health disparities. However, it is unknown if there are rural disparities in incident diabetes. We used CDC data on incidence of diagnosed diabetes in adults aged ≥20 years, available for 97.5% of US counties (n=3145/3226) . Trends in the annual age-adjusted incident diabetes rate per 1000 adults (AADR) were assessed by weighted least squares regression. Year was fitted nonlinearly with a spline function, and AADR fold-change was tested by a model-based contrast of 20vs. 2018. The average AADR of 8.7 (95% CI 8.6-8.7) ranged from 9.3 (in 2011) to 8.3 (in 2013) and 8.9 (in 2018) , and concealed subnational disparities based on rurality (Figure) . In 2018, compared with 2011, the AADR decreased for large central metro counties (most urban) with AADR fold-change of 0.92 (0.91-0.93) but increased for noncore counties (most rural) with AADR fold-change of 1. (1.01-1.08) (both P & lt;.01) . The AADR declined in counties with intermediate rurality except for micropolitan counties (no change; P=.56) . When stratified by region, the largest rural disparity in AADR was observed in the South, with smaller disparities in other regions. In summary, from 2011-2018, rural counties had the highest overall AADR. The overall disparity in trends based on county rurality and the disparity in incidence in the rural South and rural West highlight areas for diabetes primary prevention interventions. Disclosure K.R. Bailey: None. M.M. Mielke: Consultant; Biogen, LabCorp. A. Vella: Advisory Panel; Crinetics Pharmaceuticals, Inc., Rezolute, Inc., vTv Therapeutics, Zealand Pharma A/S. Other Relationship; Novo Nordisk. Funding National Institute on Minority Health and Health Disparities (NIH K23 MD016230)
    Type of Medium: Online Resource
    ISSN: 0012-1797
    URL: Article
    DOI: 10.2337/db22-1202-P
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2022
    detail.hit.zdb_id: 1501252-9
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    Online Resource
  • 4
    Online Resource
    Online Resource
    1006-P: Progression to Type 2 Diabetes Despite a Baseline Fasting Plasma Glucose ≤ 80 mg/dl in a Population-Based Cohort
    American Diabetes Association ; 2021
    In:  Diabetes Vol. 70, No. Supplement_1 ( 2021-06-01)
    Details
    In: Diabetes, American Diabetes Association, Vol. 70, No. Supplement_1 ( 2021-06-01)
    Abstract: Fasting plasma glucose (FPG) concentration is a major predictor of a person’s risk of developing diabetes mellitus (DM). However, we sought to examine characteristics of individuals who develop DM despite a baseline FPG of ≤ 80mg/dL. The Rochester Epidemiology Project (REP) links the medical records of virtually all persons who have resided in Olmsted County, MN, USA between 1966 and present. Electronic laboratory data are available from 2005. Using REP, we identified individuals with ≥ 2 FPG tests from 2005-17, after excluding people who met criteria for DM on/before their first FPG. Those who developed DM (FPG & gt; 125mg/dL) were assigned an event date as the date of their first diagnostic value. Subjects who did not develop DM were censored at their last FPG value on/before Dec 31, 2017. The entire cohort consisted of 44,815 individuals, of whom 3689 (8.2%) developed DM. Although higher baseline FPG was strongly related to development of DM, 2315 had a baseline FPG of ≤ 80mg/dL with 130 (5.6%) developing DM. Within this subset, those who progressed were older at baseline (40 ± 11 vs. 36 ± 12 years, p & lt;0.02) and were more likely to be male (38 vs. 22%, p & lt;0.001). Those who progressed had no difference between BMI at baseline and time of diagnosis (28 ± 8 vs. 29 ± 8 kg/m2, p=0.07). Medical record review suggested that individuals who progressed had high medical complexity. Specifically, 28 (22%) were repeatedly exposed to high dose glucocorticoids during follow up, including 10 (8%) who received a solid organ transplant. Fifteen (12%) had a substance abuse disorder. Nineteen (15%) were treated with insulin at one year following diagnosis, four of whom were diagnosed with type 1 DM. Twenty nine (22%) had a first degree relative with DM. Additional longitudinal follow up revealed that 20 (15%) were deceased at a median time of 2.5 years following the DM diagnosis. While progression to DM in the context of a baseline FPG of ≤ 80mg/dL is uncommon, it typically occurs in the setting of significant medical comorbidity. Disclosure A. M. Egan: None. C. Wood-wentz: None. K. R. Bailey: None. A. Vella: Research Support; Self; Novo Nordisk. Funding National Institutes of Health (DK78646, DK116231, DK126206, K12HD065987)
    Type of Medium: Online Resource
    ISSN: 0012-1797 , 1939-327X
    URL: Article
    DOI: 10.2337/db21-1006-P
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2021
    detail.hit.zdb_id: 1501252-9
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