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Diabetes Care. 2016 Sep;39(9):1550-5. doi: 10.2337/dc16-0429. Epub 2016 Jul 13.

Changes in Mortality in People With IGT Before and After the Onset of Diabetes During the 23-Year Follow-up of the Da Qing Diabetes Prevention Study.

Author information

1
Department of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China.
2
Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA guangwei_li@medmail.com.cn pzhang@cdc.gov.
3
Department of Cardiology, Da Qing First Hospital, Da Qing, China.
4
Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA.
5
Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China.
6
Department of Global Health Management and Policy, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA.
7
Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, Bethesda, MD.
8
Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ.
9
Department of Endocrinology, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China guangwei_li@medmail.com.cn pzhang@cdc.gov.

Abstract

OBJECTIVE:

People with impaired glucose tolerance (IGT) have increased risk of mortality and a high risk of progression to diabetes, but the extent that the excess mortality is associated with IGT per se or is the result of subsequent diabetes is unclear.

RESEARCH DESIGN AND METHODS:

We compared mortality before and after the development of diabetes among 542 persons with IGT initially who participated in a 6-year lifestyle diabetes prevention trial and were followed-up from 1986 to 2009.

RESULTS:

During the 23-year follow-up, 174 (32.1%) died, with an overall death rate of 15.9/1,000 person-years. The majority of deaths (74.7%; 130 of 174) occurred after progression to type 2 diabetes, with age-adjusted death rates of 11.1/1,000 person-years (95% CI 8.2-12.0) before and 19.4/1,000 person-years (95% CI 11.9-23.3) after the development of type 2 diabetes. The cumulative mortality was 37.8% (95% CI 33.1-42.2%) in participants who developed type 2 diabetes during first 10 years of follow-up, 28.6% (95% CI 21.6-35.0%) in those who progressed to type 2 diabetes in 10-20 years, and 13.9% (95% CI 7.0-20.3%) in those who did not develop to type 2 diabetes within 20 years. Time-dependent multivariate Cox proportional hazards analyses, with adjustment for baseline age, sex, intervention, and other potential confounding risk factors, showed that the development of type 2 diabetes was associated with a 73% higher risk of death (hazard ratio 1.73 [95% CI 1.18-2.52]).

CONCLUSIONS:

As elsewhere, IGT is associated with increased risk of mortality in China, but much of this excess risk is attributable to the development of type 2 diabetes.

PMID:
27411697
PMCID:
PMC5001147
DOI:
10.2337/dc16-0429
[Indexed for MEDLINE]
Free PMC Article

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