Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2009;62(05):528-34 - Vol. 62 Num.05 DOI: 10.1016/S1885-5857(09)71835-3

Mortality Risk in Spanish Adults With Diagnosed Diabetes, Undiagnosed Diabetes or Pre-Diabetes. The Asturias Study 1998-2004

Sergio Valdés a, Patricia Botas b, Elías Delgado c, Francisco Díaz Cadórniga c

a Servicio de Endocrinología y Nutrición, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain. Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Málaga, Spain. CIBER de Diabetes y Enfermedades Metabólicas Asociadas, CIBERDEM, Málaga, Spain
b Servicio de Medicina Interna, Sección de Endocrinología, Hospital San Agustín, Avilés, Asturias, Spain
c Servicio de Endocrinología y Nutrición, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain

Keywords

Type-2 diabetes. Mortality. Undiagnosed diabetes. Pre-diabetes. Spain.

Abstract

Introduction and Objectives. Although type-2 diabetes is a well-known cause of death, the mortality associated with undiagnosed diabetes and early-stage dysglycemia has not been clearly determined. Methods. This study included 1015 individuals aged 30-75 years who took part in the first phase of the Asturias study (1998-1999). Participants completed a questionnaire and underwent a physical examination and an oral glucose tolerance test (OGTT). All deaths that occurred in the cohort within 6 years of follow-up (ie December 1998 to December 2004) were recorded. Results. Participants were divided into four groups according to the condition indicated by their OGTT result in the first phase of the study: normoglycemia, pre-diabetes, undiagnosed diabetes, or diagnosed diabetes (World Health Organization 1999 criteria). A total of 42 deaths were recorded during follow-up. With normoglycemic individuals acting as a control group, multivariate analysis showed that the relative risk of mortality was 2.5 (95% CI, 1-6.3) in the group with diagnosed diabetes, 2.7 (95% CI, 1.1-6.7) in the group with undiagnosed diabetes, and 1.6 (95% CI, 0.7-4) in the group with pre-diabetes. Conclusions. Both individuals with diagnosed diabetes and those with undiagnosed diabetes had a risk of mortality around 2.5-3 times greater than individuals with normoglycemia. Those with pre-diabetes also had increased mortality relative to the control group, though the difference was not significant. multivariate analysis showed that the relative risk of mortality was 2.5 (95% CI, 1-6.3) in the group with diagnosed diabetes, 2.7 (95% CI, 1.1-6.7) in the group with undiagnosed diabetes and 1.6 (95% CI, 0.7-4) in the group with pre-diabetes. Conclusions. Both individuals with diagnosed diabetes and those with undiagnosed diabetes had a risk of mortality around 2.5-3 times greater than individuals with normoglycemia. Those with pre-diabetes also had increased mortality relative to the control group, though the difference was not significant.

1885-5857/© 2009 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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