Estimating the delay between onset and diagnosis of type 2 diabetes from the time-course of retinopathy prevalence
| Autor: | Marina Trento, Dario Cipullo, Sabrina Di Miceli, Franco Cavallo, Anna Viola Taulaigo, Paola Dalmasso, Giulia Curletto, Antonella Cenci, Pietro Passera, Massimo Porta, Roberta Rigault De La Longrais |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Research design medicine.medical_specialty Pediatrics Time Factors Endocrinology Diabetes and Metabolism medicine.medical_treatment Type 2 diabetes Diabetes mellitus Prevalence Internal Medicine medicine Humans Prospective Studies Age of Onset Prospective cohort study Advanced and Specialized Nursing Diabetic Retinopathy business.industry Insulin Diabetic retinopathy Middle Aged medicine.disease Surgery Diabetes Mellitus Type 2 Italy Linear Models Female Age of onset business Follow-Up Studies Retinopathy |
| Popis: | OBJECTIVE By correlating known diabetes duration with the prevalence of retinopathy, more than 10 years have been estimated to lapse between the onset and diagnosis of type 2 diabetes. Such calculations, however, assumed a linear model, included stages of retinopathy not specific to diabetes, and allowed 5 years for retinopathy to occur after the onset of diabetes. We calculated the duration of undiagnosed type 2 diabetes in outpatients screened for retinopathy in a hospital-based diabetes clinic after correcting these assumptions. RESEARCH DESIGN AND METHODS Diabetic patients (n = 12,074; 35,545 fundus examinations) were stratified into younger onset (YO; age at onset RESULTS There were 1,719 patients in the OO-NIT group with AnyDR and 685 with ModDR and 756 in the YO-IT group with AnyDR and 385 with ModDR. A linear model showed ModDR appeared 2.66 years before diagnosis among those in the OO-NIT group. A quadratic model suggested that ModDR appeared 3.29 years after diagnosis among those in the YO-IT group. The resulting estimate was 6.05 years (2.66 + 3.29) between the onset and diagnosis of diabetes, compared with 13.36 years using standard criteria. CONCLUSIONS Using best-fitting models and stratifying by glucose-lowering treatment and severity of retinopathy substantially lowers the estimated duration of undiagnosed type 2 diabetes. |
| Databáze: | OpenAIRE |
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