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  • American Diabetes Association  (4)
  • English  (4)
  • 2005-2009  (4)
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  • American Diabetes Association  (4)
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  • English  (4)
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  • 2005-2009  (4)
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  • 1
    Online Resource
    Online Resource
    HbA1c and Peripheral Arterial Disease in Diabetes
    American Diabetes Association ; 2006
    In:  Diabetes Care Vol. 29, No. 4 ( 2006-04-01), p. 877-882
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 29, No. 4 ( 2006-04-01), p. 877-882
    Abstract: OBJECTIVE—To assess the relation between HbA1c (A1C) and incident peripheral arterial disease (PAD) in a community-based cohort of diabetic adults from the Atherosclerosis Risk in Communities (ARIC) study. A second aim was to investigate whether the association was stronger for severe, symptomatic disease compared with PAD assessed by low ankle-brachial index (ABI). RESEARCH DESIGN AND METHODS—This was a prospective cohort study of 1,894 individuals with diabetes using ARIC visit 2 as baseline (1990–1992) with follow-up for incident PAD through 2002. We assessed the relation between A1C and incident PAD, defined by intermittent claudication, PAD-related hospitalization, or a low ABI ( & lt;0.9). RESULTS—During a mean follow-up of 9.8 years, the crude incidence rates were 2.1 per 1,000 person-years for intermittent claudication (n = 41), 2.9 per 1,000 person-years for PAD-related hospitalization (n = 57), and 18.9 per 1,000 person-years for low ABI at visit 3 or 4 (n = 123). The relative risk (RR) (95% CI) of an incident PAD event comparing the second and third tertiles of A1C to the first, respectively, after adjustment for cardiovascular risk factors was strongest for severe, symptomatic forms of disease, e.g., PAD-related hospitalization (RR = 4.56 [1.86–11.18] for the third A1C tertile compared with the first, P trend & lt;0.001) than for low ABI (RR = 1.64 [0.94–2.87], P trend = 0.08). CONCLUSIONS—We found a positive, graded, and independent association between A1C and PAD risk in diabetic adults. This association was stronger for clinical (symptomatic) PAD, whose manifestations may be related to microvascular insufficiency, than for low ABI. Our results suggest that efforts to improve glycemic control in persons with diabetes may substantially reduce the risk of PAD.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.29.04.06.dc05-2018
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2006
    detail.hit.zdb_id: 1490520-6
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    Online Resource
  • 2
    Online Resource
    Online Resource
    Parity and Risk of Type 2 Diabetes
    American Diabetes Association ; 2006
    In:  Diabetes Care Vol. 29, No. 11 ( 2006-11-01), p. 2349-2354
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 29, No. 11 ( 2006-11-01), p. 2349-2354
    Abstract: OBJECTIVE—While high parity is hypothesized to be associated with insulin resistance and type 2 diabetes, few studies have examined this association in diverse racial samples or geographical areas. Our objectives were to estimate the magnitude of association between parity and diabetes and to determine if higher parity is predictive of future risk of diabetes. RESEARCH DESIGN AND METHODS—This was a population-based, prospective cohort study of 7,024 Caucasian and African-American women from the Atherosclerosis Risk in Communities study, a prospective epidemiological study of men and women aged 45–64 years, with 9 years of follow-up. Incident diabetes was defined by the 1997 American Diabetes Association diagnostic criteria. Parity was defined as the number of live births (no live births [nulliparity], one to two live births, three to four live births, and five or more live births [grandmultiparity] ). Parity and risk of diabetes was estimated for 754 incident cases of diabetes with Cox proportional hazard regression models, adjusting for sociodemographic, clinical, and lifestyle factors and inflammatory markers. RESULTS—Incidence rates were highest among women with five or more live births (23/1,000 person-years [95% CI 20.3–26.7]) and lowest among women with one to two live births (11/1,000 person-years [9.6–12.5] ). Adjustment indicated that much of the risk was due to sociodemographic factors and higher obesity, but after adjustment for all covariates, grandmultiparity (five or more) was still associated with a 27% increased risk for diabetes (hazard ratio 1.27 [95% CI 1.02–1.57]). CONCLUSIONS—Grandmultiparity is predictive of future risk of diabetes after adjustment for confounders.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/dc06-0825
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2006
    detail.hit.zdb_id: 1490520-6
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    Online Resource
  • 3
    Online Resource
    Online Resource
    The Burden and Treatment of Diabetes in Elderly Individuals in the U.S.
    American Diabetes Association ; 2006
    In:  Diabetes Care Vol. 29, No. 11 ( 2006-11-01), p. 2415-2419
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 29, No. 11 ( 2006-11-01), p. 2415-2419
    Abstract: OBJECTIVE—To assess the prevalence of diabetes, distinguishing between elderly individuals with diabetes diagnosed in middle age (“middle age–onset diabetes”) from elderly individuals with recently diagnosed diabetes (“elderly onset diabetes”) and to assess the burden of complications and control of cardiovascular risk factors in these groups. RESEARCH DESIGN AND METHODS—We analyzed data from 2,809 elderly individuals from the 1999–2002 National Health and Nutrition Examination Survey, a cross-sectional nationally representative survey of the civilian noninstitutionalized population of the U.S. RESULTS—Among adults aged ≥65 years, the prevalence of diagnosed diabetes was 15.3%, representing 5.4 million individuals in the U.S. The prevalence of undiagnosed diabetes was 6.9% or 2.4 million individuals. Elderly individuals with middle age–onset diabetes had a much greater burden of microvascular disease but have a similar burden of macrovascular disease compared with individuals with elderly onset diabetes. Elderly individuals with middle age–onset diabetes had substantially worse glycemic control (proportion of individuals with HbA1c & gt;7% = 59.9%) compared with either elderly onset (41.6%) or nonelderly individuals with diabetes (55.3%). Individuals with elderly onset diabetes were also less likely to be taking glucose-lowering medications. CONCLUSIONS—In this study, we documented a high prevalence of diabetes among elderly individuals and high rate of poor glycemic control in this population. Individuals with middle age–and elderly onset diabetes appear to represent distinct groups with differing burdens of disease and possibly differing treatment goals. Future studies of diabetes in elderly individuals may need to consider stratification based on age of diagnosis.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/dc06-1058
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2006
    detail.hit.zdb_id: 1490520-6
    Location Call Number Limitation Availability
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    Online Resource
  • 4
    Online Resource
    Online Resource
    Glycemic Control, Atherosclerosis, and Risk Factors for Cardiovascular Disease in Individuals With Diabetes
    American Diabetes Association ; 2005
    In:  Diabetes Care Vol. 28, No. 8 ( 2005-08-01), p. 1965-1973
    Details
    In: Diabetes Care, American Diabetes Association, Vol. 28, No. 8 ( 2005-08-01), p. 1965-1973
    Abstract: OBJECTIVE—Glycemic control (HbA1c [A1C]) is strongly associated with microvascular disease in individuals with diabetes, but its relation to macrovascular disease and atherosclerosis is less clear. This study examines the relationship between A1C, carotid intima-media thickness (IMT), and traditional cardiovascular risk factors in individuals with diabetes. RESEARCH DESIGN AND METHODS—A cross-sectional study of 2,060 people with diagnosed and undiagnosed (unrecognized) diabetes in the Atherosclerosis Risk in Communities study was performed. RESULTS—LDL and HDL cholesterol, plasma triglycerides, and waist-to-hip ratio were significantly associated with A1C after multivariable adjustment. African Americans with undiagnosed and diagnosed diabetes had significantly elevated A1C values compared with whites, even after adjustment for potentially confounding factors. There was a graded association between A1C and carotid IMT. In a fully adjusted model in individuals with undiagnosed diabetes, the odds ratio (OR) of being in the highest quartile of IMT versus the lowest was 2.46 (95% CI 1.16–5.03, comparing the highest quartile of A1C to the lowest). In people with diagnosed diabetes, the comparable OR was 2.62 (1.36–5.06). CONCLUSIONS—This study identified several important associations between A1C and known risk factors for cardiovascular disease and suggested that A1C is independently related to carotid IMT. Chronically elevated glucose levels may contribute to the development of atherosclerosis in people with diabetes, independent of other risk factors.
    Type of Medium: Online Resource
    ISSN: 0149-5992 , 1935-5548
    URL: Article
    DOI: 10.2337/diacare.28.8.1965
    Language: English
    Publisher: American Diabetes Association
    Publication Date: 2005
    detail.hit.zdb_id: 1490520-6
    Location Call Number Limitation Availability
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    Online Resource
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