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Impact of age, age at diagnosis and duration of diabetes on the risk of macrovascular and microvascular complications and death in type 2 diabetes

Aims/hypothesis Data are inconsistent regarding the associations between age, age at diagnosis of diabetes, diabetes duration and subsequent vascular complications. Methods The associations between age (or age at diagnosis), diabetes duration and major macrovascular events, all-cause death and major... Full description

Journal Title: Diabetologia 2014-09-17, Vol.57 (12), p.2465-2474
Main Author: Zoungas, Sophia
Other Authors: Woodward, Mark , Li, Qiang , Cooper, Mark E , Hamet, Pavel , Harrap, Stephen , Heller, Simon , Marre, Michel , Patel, Anushka , Poulter, Neil , Williams, Bryan , Chalmers, John
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Berlin/Heidelberg: Springer Berlin Heidelberg
ID: ISSN: 0012-186X
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title: Impact of age, age at diagnosis and duration of diabetes on the risk of macrovascular and microvascular complications and death in type 2 diabetes
format: Article
creator:
  • Zoungas, Sophia
  • Woodward, Mark
  • Li, Qiang
  • Cooper, Mark E
  • Hamet, Pavel
  • Harrap, Stephen
  • Heller, Simon
  • Marre, Michel
  • Patel, Anushka
  • Poulter, Neil
  • Williams, Bryan
  • Chalmers, John
subjects:
  • Age Factors
  • Age of Onset
  • Aged
  • Article
  • Biological and medical sciences
  • Blood and lymphatic vessels
  • Blood circulation disorders
  • Blood Glucose
  • Cardiology. Vascular system
  • Complications and side effects
  • Dextrose
  • Diabetes Mellitus, Type 2 - complications
  • Diabetes Mellitus, Type 2 - drug therapy
  • Diabetes Mellitus, Type 2 - mortality
  • Diabetes. Impaired glucose tolerance
  • Diabetic Angiopathies - drug therapy
  • Diabetic Angiopathies - mortality
  • Diagnosis
  • Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
  • Endocrine pancreas. Apud cells (diseases)
  • Endocrinopathies
  • Etiopathogenesis. Screening. Investigations. Target tissue resistance
  • Female
  • Glucose
  • Glucose metabolism
  • Human Physiology
  • Humans
  • Hypoglycemic Agents - therapeutic use
  • Internal Medicine
  • Male
  • Medical sciences
  • Medicine
  • Medicine & Public Health
  • Metabolic Diseases
  • Middle Aged
  • Mortality
  • Prognosis
  • Risk Factors
  • Treatment Outcome
  • Type 2 diabetes
ispartof: Diabetologia, 2014-09-17, Vol.57 (12), p.2465-2474
description: Aims/hypothesis Data are inconsistent regarding the associations between age, age at diagnosis of diabetes, diabetes duration and subsequent vascular complications. Methods The associations between age (or age at diagnosis), diabetes duration and major macrovascular events, all-cause death and major microvascular events were examined in 11,140 patients with type 2 diabetes randomly allocated to intensive or standard glucose control in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial. Rates were calculated by 5 year baseline age (or age at diagnosis) and diabetes duration strata. Risks were estimated using Cox models adjusted for treatment assignment and HbA 1c . Results The mean age (±SD) was 65.8 ± 6.4 years, age at diagnosis was 57.8 ± 8.7 years and diabetes duration was 7.9 ± 6.4 years. Diabetes duration was associated with the risk of macrovascular events (HR 1.13 [95% CI 1.08, 1.17]), microvascular events (1.28 [1.23, 1.33]) and death (1.15 [1.10, 1.20]) whereas age (or age at diagnosis) was only associated with the risk of macrovascular events (1.33 [1.27, 1.39]) and death (1.56 [1.48, 1.64]). No interaction was observed between diabetes duration, age and the risk of macrovascular events or death (both p  > 0.4). However, an interaction was observed between diabetes duration, age and the risk of microvascular events ( p  = 0.002), such that the effects of increasing diabetes duration were greatest at younger rather than older age. Conclusions/interpretation In patients with type 2 diabetes, age or age at diagnosis and diabetes duration are independently associated with macrovascular events and death whereas only diabetes duration is independently associated with microvascular events and this effect is greater in the youngest patients.
language: eng
source:
identifier: ISSN: 0012-186X
fulltext: no_fulltext
issn:
  • 0012-186X
  • 1432-0428
url: Link


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titleImpact of age, age at diagnosis and duration of diabetes on the risk of macrovascular and microvascular complications and death in type 2 diabetes
creatorZoungas, Sophia ; Woodward, Mark ; Li, Qiang ; Cooper, Mark E ; Hamet, Pavel ; Harrap, Stephen ; Heller, Simon ; Marre, Michel ; Patel, Anushka ; Poulter, Neil ; Williams, Bryan ; Chalmers, John
creatorcontribZoungas, Sophia ; Woodward, Mark ; Li, Qiang ; Cooper, Mark E ; Hamet, Pavel ; Harrap, Stephen ; Heller, Simon ; Marre, Michel ; Patel, Anushka ; Poulter, Neil ; Williams, Bryan ; Chalmers, John ; ADVANCE Collaborative group ; for the ADVANCE Collaborative group
descriptionAims/hypothesis Data are inconsistent regarding the associations between age, age at diagnosis of diabetes, diabetes duration and subsequent vascular complications. Methods The associations between age (or age at diagnosis), diabetes duration and major macrovascular events, all-cause death and major microvascular events were examined in 11,140 patients with type 2 diabetes randomly allocated to intensive or standard glucose control in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial. Rates were calculated by 5 year baseline age (or age at diagnosis) and diabetes duration strata. Risks were estimated using Cox models adjusted for treatment assignment and HbA 1c . Results The mean age (±SD) was 65.8 ± 6.4 years, age at diagnosis was 57.8 ± 8.7 years and diabetes duration was 7.9 ± 6.4 years. Diabetes duration was associated with the risk of macrovascular events (HR 1.13 [95% CI 1.08, 1.17]), microvascular events (1.28 [1.23, 1.33]) and death (1.15 [1.10, 1.20]) whereas age (or age at diagnosis) was only associated with the risk of macrovascular events (1.33 [1.27, 1.39]) and death (1.56 [1.48, 1.64]). No interaction was observed between diabetes duration, age and the risk of macrovascular events or death (both p  > 0.4). However, an interaction was observed between diabetes duration, age and the risk of microvascular events ( p  = 0.002), such that the effects of increasing diabetes duration were greatest at younger rather than older age. Conclusions/interpretation In patients with type 2 diabetes, age or age at diagnosis and diabetes duration are independently associated with macrovascular events and death whereas only diabetes duration is independently associated with microvascular events and this effect is greater in the youngest patients.
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subjectAge Factors ; Age of Onset ; Aged ; Article ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood circulation disorders ; Blood Glucose ; Cardiology. Vascular system ; Complications and side effects ; Dextrose ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - mortality ; Diabetes. Impaired glucose tolerance ; Diabetic Angiopathies - drug therapy ; Diabetic Angiopathies - mortality ; Diagnosis ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Female ; Glucose ; Glucose metabolism ; Human Physiology ; Humans ; Hypoglycemic Agents - therapeutic use ; Internal Medicine ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Metabolic Diseases ; Middle Aged ; Mortality ; Prognosis ; Risk Factors ; Treatment Outcome ; Type 2 diabetes
ispartofDiabetologia, 2014-09-17, Vol.57 (12), p.2465-2474
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7Marre, Michel
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descriptionAims/hypothesis Data are inconsistent regarding the associations between age, age at diagnosis of diabetes, diabetes duration and subsequent vascular complications. Methods The associations between age (or age at diagnosis), diabetes duration and major macrovascular events, all-cause death and major microvascular events were examined in 11,140 patients with type 2 diabetes randomly allocated to intensive or standard glucose control in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial. Rates were calculated by 5 year baseline age (or age at diagnosis) and diabetes duration strata. Risks were estimated using Cox models adjusted for treatment assignment and HbA 1c . Results The mean age (±SD) was 65.8 ± 6.4 years, age at diagnosis was 57.8 ± 8.7 years and diabetes duration was 7.9 ± 6.4 years. Diabetes duration was associated with the risk of macrovascular events (HR 1.13 [95% CI 1.08, 1.17]), microvascular events (1.28 [1.23, 1.33]) and death (1.15 [1.10, 1.20]) whereas age (or age at diagnosis) was only associated with the risk of macrovascular events (1.33 [1.27, 1.39]) and death (1.56 [1.48, 1.64]). No interaction was observed between diabetes duration, age and the risk of macrovascular events or death (both p  > 0.4). However, an interaction was observed between diabetes duration, age and the risk of microvascular events ( p  = 0.002), such that the effects of increasing diabetes duration were greatest at younger rather than older age. Conclusions/interpretation In patients with type 2 diabetes, age or age at diagnosis and diabetes duration are independently associated with macrovascular events and death whereas only diabetes duration is independently associated with microvascular events and this effect is greater in the youngest patients.
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12Diabetes Mellitus, Type 2 - drug therapy
13Diabetes Mellitus, Type 2 - mortality
14Diabetes. Impaired glucose tolerance
15Diabetic Angiopathies - drug therapy
16Diabetic Angiopathies - mortality
17Diagnosis
18Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
19Endocrine pancreas. Apud cells (diseases)
20Endocrinopathies
21Etiopathogenesis. Screening. Investigations. Target tissue resistance
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23Glucose
24Glucose metabolism
25Human Physiology
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27Hypoglycemic Agents - therapeutic use
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30Medical sciences
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32Medicine & Public Health
33Metabolic Diseases
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titleImpact of age, age at diagnosis and duration of diabetes on the risk of macrovascular and microvascular complications and death in type 2 diabetes
authorZoungas, Sophia ; Woodward, Mark ; Li, Qiang ; Cooper, Mark E ; Hamet, Pavel ; Harrap, Stephen ; Heller, Simon ; Marre, Michel ; Patel, Anushka ; Poulter, Neil ; Williams, Bryan ; Chalmers, John
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4Biological and medical sciences
5Blood and lymphatic vessels
6Blood circulation disorders
7Blood Glucose
8Cardiology. Vascular system
9Complications and side effects
10Dextrose
11Diabetes Mellitus, Type 2 - complications
12Diabetes Mellitus, Type 2 - drug therapy
13Diabetes Mellitus, Type 2 - mortality
14Diabetes. Impaired glucose tolerance
15Diabetic Angiopathies - drug therapy
16Diabetic Angiopathies - mortality
17Diagnosis
18Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
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atitleImpact of age, age at diagnosis and duration of diabetes on the risk of macrovascular and microvascular complications and death in type 2 diabetes
jtitleDiabetologia
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date2014-09-17
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abstractAims/hypothesis Data are inconsistent regarding the associations between age, age at diagnosis of diabetes, diabetes duration and subsequent vascular complications. Methods The associations between age (or age at diagnosis), diabetes duration and major macrovascular events, all-cause death and major microvascular events were examined in 11,140 patients with type 2 diabetes randomly allocated to intensive or standard glucose control in the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial. Rates were calculated by 5 year baseline age (or age at diagnosis) and diabetes duration strata. Risks were estimated using Cox models adjusted for treatment assignment and HbA 1c . Results The mean age (±SD) was 65.8 ± 6.4 years, age at diagnosis was 57.8 ± 8.7 years and diabetes duration was 7.9 ± 6.4 years. Diabetes duration was associated with the risk of macrovascular events (HR 1.13 [95% CI 1.08, 1.17]), microvascular events (1.28 [1.23, 1.33]) and death (1.15 [1.10, 1.20]) whereas age (or age at diagnosis) was only associated with the risk of macrovascular events (1.33 [1.27, 1.39]) and death (1.56 [1.48, 1.64]). No interaction was observed between diabetes duration, age and the risk of macrovascular events or death (both p  > 0.4). However, an interaction was observed between diabetes duration, age and the risk of microvascular events ( p  = 0.002), such that the effects of increasing diabetes duration were greatest at younger rather than older age. Conclusions/interpretation In patients with type 2 diabetes, age or age at diagnosis and diabetes duration are independently associated with macrovascular events and death whereas only diabetes duration is independently associated with microvascular events and this effect is greater in the youngest patients.
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pubSpringer Berlin Heidelberg
pmid25226881
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