Mortality and cardiovascular outcomes in patients detected by screening or clinically diagnosed type 2 diabetes.: A 30-year follow-up study of 740 incident patients with type 2 diabetes
(English)In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548Article in journal (Refereed) Submitted
Screening for type 2 diabetes among high-risk subjects is recommended by many organizations. The aim of this study was to analyse all-cause mortality and cardiovascular disease (CVD) outcomes in type 2 diabetes subjects detected by screening and those clinically diagnosed during 30 years of follow-up.
Research design and methods
A diabetes register was established at the primary healthcare centre (PHCC) in Laxå, beginning in 1972 and based on data from clinical records with information on medical treatment and laboratory data as well as information on all-cause mortality, CVD, myocardial infarction (MI), and stroke events from National Registers. A total of 740 incident patients with type 2 diabetes were registered between 1972- 2001. In addition, case-finding procedures involving 85% of residents aged 35 to 79 were performed from 1983 onwards.
Baseline characteristics showed a significantly higher CVD risk, mainly depending on more prevalent CVD events in the screened as compared with the clinically detected group (propensity score 0.59 vs. 0.46, p<0.0001). After a mean follow-up of 10 and 11.5 years for screening detected and clinically detected subjects respectively, HRs incidences were for all-cause mortality 1.01 (p=0.97), CVD 1.00 (p=0.99), and MI 1.03 (p=0.87). For stroke a 24% non-significant lower risk for screening detected as compared with clinically detected subjects were found, HR 0.76 (p=0.15).
No reduction in total mortality and CVD outcomes was found in type 2 diabetes subjects detected by screening as compared with those clinically diagnosed, even though stroke incidence tended to be lower.
Diabetes, screening, clinically diagnosed, macrovascular outcomes, longitudinal
Research subject Family Medicine
IdentifiersURN: urn:nbn:se:uu:diva-210918OAI: oai:DiVA.org:uu-210918DiVA: diva2:667549