Clinical Summary

Prediabetes and Vascular Disease Risk in Newly Diagnosed T2D

Sarfaroj Khan

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.