High fasting blood sugar and central adiposity increase complications in diabetes
USA: The risk for various diabetes complications varies by diabetes subgroups, finds a recent study in the Journal of Diabetes and its Complications. The risk was found to be particularly high in those with a high waist circumference, high fasting blood sugar levels, and early age at diabetes onset.
Michael P. Bancks, Wake Forest School of Medicine, Department of Epidemiology and Prevention, Winston-Salem, NC, USA, and colleagues aimed to characterize diabetes subgroups among a multi-ethnic cohort and assess risk for incident complications.
For the purpose, 1587 participants from the Multi-Ethnic Study of Atherosclerosis with diabetes were included. Eight diabetes subgroups were characterized according to absolute thresholds for disease characteristics: age at diabetes diagnosis (≤45 years), fasting glucose (FG ≥7.7 mmol/L; ≥140 mg/dL), and waist circumference (women ≥105 cm; men ≥110 cm).
Risk for incident cardiovascular disease, mortality, heart failure, chronic kidney disease, retinopathy, and dementia were estimated over 17 years.
Key findings of the study include:
- The subgroup with both high fasting blood sugar and early age at onset was associated with higher risk for death, CVD, heart failure, CKD, and retinopathy and the subgroup with both early age at onset and high waist circumference was associated CVD, heart failure, CKD, and retinopathy.
- The subgroup that met all three high-risk thresholds had greater risk for death, heart failure, CKD, and retinopathy.
- The researchers did not observe evidence for synergistic or antagonistic joint effects of the high-risk characteristics for any outcome.
"Our work supports differential risk for various diabetes complications among exclusive subgroups defined by age at diabetes onset, fasting blood sugar, and central adiposity," concluded the authors. Careful monitoring and risk reduction are essential for individuals with these characteristics.
There is differential risk for death, CVD, HF, dementia, CKD, and retinopathy by subgroup. Further there is no synergistic or antagonistic joint effects among diabetes subgroup risk factors.Clinicians are advised to use findings to communicate risks and guide preventive strategies.
The study titled, "Diabetes subgroups and risk for complications: The Multi-Ethnic Study of Atherosclerosis (MESA)," is published in the Journal of Diabetes and its Complications.