Prediabetes and vascular disease risk in newly diagnosed T2D

  • Palladino R & al.
  • BMJ Open Diabetes Res Care
  • 1 Apr 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Microvascular and macrovascular diseases were frequently detected at the time of type 2 diabetes (T2D) diagnosis.
  • Individuals with prior prediabetes were at an increased risk of microvascular disease and acute coronary syndrome at the time of T2D diagnosis.

Why this matters

  • Detection of prediabetes might lower the microvascular and macrovascular disease burden through increased awareness in terms of screening for vascular complications.

Study design

  • This observational study included 159,736 individuals with newly diagnosed T2D using data from the UK Clinical Practice Research Datalink (CPRD) database between 2004 and 2017.
  • The presence of microvascular and macrovascular diseases was assessed by glycaemic status within 3 years before T2D diagnosis.
  • Funding: None disclosed.

Key results

  • 49.9% of the study population had ≥1 vascular disease; 37.4% had microvascular disease and 23.5% had macrovascular disease at the time of T2D diagnosis.
  • At the time of diabetes diagnosis, individuals with prediabetes vs those with normal glycaemic values were at an increased risk of:
    • retinopathy (adjusted OR [aOR], 1.76; 95% CI, 1.69-1.85);
    • nephropathy (aOR, 1.14; 95% CI, 1.10-1.19); and
    • acute coronary syndrome (aOR, 1.07; 95% CI, 1.03-1.12).
  • Individuals with prior prediabetes had lower odds of a diagnosis of cerebrovascular events (aOR, 0.88; 95% CI, 0.82-0.94) and peripheral arterial disease (aOR, 0.88; 95% CI, 0.81-0.96) vs those with normal glycaemic values.

Limitations

  • The duration individuals remained in the prediabetes state before progressing to T2D was not assessed.
  • Data on clinical variables such as blood pressure, body mass index, total cholesterol, and glycated haemoglobin were missing.