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Type 2 diabetes mortality prediction equations may assist in patient management
McEwen LN. Diabetes Care. 2012;doi:10.2337/dc11-2281.
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Demographic, socioeconomic and biological risk factors may be useful in predicting risk for death among those with type 2 diabetes. With further substantiation, these prediction equations may aid in patient management, according to the researchers.
“These prediction equations may be incorporated into computer simulation models of disease progression,” the researchers wrote. “After further validation, clinicians may also use such equations to inform patients about their risk for mortality and to target the most modifiable risk factors for intervention.”
The researchers collected 8 years of patient data (n=8,334) from survey and medical record information gathered in a multicenter, prospective, observational study called Translating Research Into Action for Diabetes (TRIAD). Their aim was to assess demographic, socioeconomic and biological risk factors for all-cause cardiovascular and non-CV mortality among patients with type 2 diabetes.
During the 8-year period, the researchers obtained data on deaths from the National Death Index. They examined predictors such as age, sex, race, education, income, smoking, age at diagnosis, duration and treatment of diabetes, BMI, complications, comorbidities and medication use.
Nineteen percent of patients died during the 8-year period.
Predictors of CV mortality included: older age; male sex; non-Hispanic white race; lower income; treatment of diabetes with insulin (with or without an oral medication); higher BMI; current smoking; higher LDL cholesterol; history of nephropathy; history of transient ischemic attack, stroke or endarterectomy; history of angina; myocardial infarction; other coronary heart disease; coronary angioplasty or coronary bypass; history of peripheral vascular disease or peripheral vascular surgery; and use of diuretics, beta-blockers or other antihypertensive or cholesterol-lowering medications.
Predictors of non-CV mortality included: older age, male sex, lower income, current smoking, history of nephropathy, history of congestive heart failure, use of a diuretic and a higher Charlson index.
“Although our equations need to be validated in other populations, they highlight the importance of specific demographic and biological risk factors for mortality in people with type 2 diabetes and provide a quantitative assessment of risk.”
Disclosure: The researchers report no relevant financial disclosures.