Mortality associated with less intense risk-factor control among adults with diabetes in the United States

Autor: Henry S. Kahn, Sharon Saydah, Mohammed K. Ali, Edward W. Gregg
Rok vydání: 2018
Předmět:
Blood Glucose
Male
Time Factors
Endocrinology
Diabetes and Metabolism
Blood Pressure
Comorbidity
Kaplan-Meier Estimate
030204 cardiovascular system & hematology
chemistry.chemical_compound
0302 clinical medicine
Risk Factors
030212 general & internal medicine
Aged
80 and over
Nutrition and Dietetics
Anticholesteremic Agents
Hazard ratio
Middle Aged
Nutrition Surveys
Cholesterol
Treatment Outcome
Hypertension
Female
Family Practice
Adult
medicine.medical_specialty
National Health and Nutrition Examination Survey
Risk Assessment
National Death Index
Young Adult
03 medical and health sciences
Diabetes mellitus
Diabetes Mellitus
Internal Medicine
medicine
Humans
Hypoglycemic Agents
Risk factor
Antihypertensive Agents
Aged
Dyslipidemias
Proportional Hazards Models
Glycated Hemoglobin
Proportional hazards model
business.industry
medicine.disease
United States
Surgery
Blood pressure
chemistry
Glycated hemoglobin
business
Biomarkers
Demography
Zdroj: Primary Care Diabetes. 12:3-12
ISSN: 1751-9918
DOI: 10.1016/j.pcd.2017.07.004
Popis: Determine the mortality experience among adults with diabetes in meeting and not meeting less intense control for glycated hemoglobin (HbA1c), blood pressure (BP), and cholesterol.National Health and Nutrition Examination Survey 1999-2010 participants with self-report of diagnosed diabetes (N=3335), measured HbA1c, BP and non-HDL cholesterol were linked to the National Death Index through December 31, 2011. Proportional hazards models were used to estimate hazard ratios (HR) of meeting HbA1c9% and BP160/110, and non-HDL cholesterol190mg/dL. Models used age as the time scale and adjusted for demographics (sex, race/ethnicity, education), diabetes duration, history of cardiovascular and chronic kidney disease, and treatments for elevated glucose, BP, and cholesterol.Over a mean 5.4 person-years of follow-up, participants meeting all less intense control had a 37% lower mortality (HR=0.63, 95% CI 0.54, 0.74) relative to those who did not meet the goals. Of approximately 306,000 deaths per year that occur among Americans with diabetes, we estimate 39,400 might have been averted by improving the care of those who have not met these less intense control goals.Meeting the less intense control goals is associated with 37% reduction in mortality and could lead to 39,400 fewer deaths per year.
Databáze: OpenAIRE
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