Changes over time in the prevalence and quality of care of type 2 diabetes in Italy: The Casale Monferrato Surveys, 1988 and 2000

Bruno, Graziella; Merletti, Franco; Bargero, G; Melis, Deborah; Masi, Ilaria; Ianni, Angela; Novelli, Giulia; Pagano, Gianfranco; Cavallo‐Perin, P.

doi:10.1016/j.numecd.2006.08.007

Cited by 30 publications

(27 citation statements)

References 30 publications

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“…The present study was carried out in the second population-based prevalence survey of the Casale Monferrato Study, which identified 3249 people with a previous diagnosis of type 2 diabetes [15]–[16]. As described in detail elsewhere, participants were identified from diabetes clinics and other administrative data sources, obtaining high estimated completeness of ascertainment.…”

Section: Methodsmentioning

confidence: 99%

“…AER was measured by nephelometry (Behring Nephelometer Analyzer, Behring Institute, Marburg, Germany, coefficient of variation 4%) on single overnight urine collections and categorised as either normoalbuminuria (<20 µg/min) or micro/macroalbuminuria (≥20 µg/min). Serum NT-proBNP levels were measured by a two-site sandwich electrochemiluminescence immunoassay (Elecsys proBNP II, Roche Diagnostic, Mannheim, Germany), using a Modular Analytics Evo analyzer with a E170 module (Roche) as previously described [16]. The intra-assay variation was below 3.0% and total coefficient of variation ranges between 2.2 and 5.8% in low and high ranges of NT-proBNP.…”

Section: Methodsmentioning

confidence: 99%

“…In this study we have assessed the predictive role of central obesity on mortality in people with type 2 diabetes recruited as part of the Casale Monferrato Study, an ongoing population-based study on the epidemiology of diabetes in Italy, after having excluded those who had other chronic diseases impairing short-term survival [15]–[16]. Aims of the present analyses were: 1) to assess the role of central obesity on 6-years mortality risk in diabetic people without other chronic diseases; 2) to define whereas age at the baseline examination was a modifier of the relationship between central obesity and mortality; 3) to examine the effect of NT-proBNP on this associations.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Age and NT-proBNP on the Association of Central Obesity with 6-Years Cardiovascular Mortality of Middle-Aged and Elderly Diabetic People: The Population-Based Casale Monferrato Study

et al. 2014

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BackgroundAmong people with type 2 diabetes the relationship between central obesity and cardiovascular mortality has not been definitely assessed. Moreover, NT-proBNP is negatively associated with central obesity, but no study has examined their combined effect on survival. We have examined these issues in a well-characterized population-based cohort.Methods and FindingsSurvival data of 2272 diabetic people recruited in 2000 who had no other chronic disease have been updated to 31 December 2006. NT-proBNP was measured in a subgroup of 1690 patients. Cox proportional hazards modeling was employed to estimate the independent associations between cardiovascular and all-cause mortality and waist circumference. Mean age was 67.9 years, 49.3% were men. Both age and NT-proBNP were negatively correlated with waist circumference (r = −0.11, p<0.001 and r = −0.07, p = 0.002). Out of 2272 subjects, 520 deaths (221 for CV mortality) occurred during a median follow-up of 5.4 years. Central obesity was not associated with CV mortality (hazard ratio, HR, adjusted for age, sex, diabetes duration, 1.14, 95% CI 0.86–1.52). NTproBNP was a negative confounder and age a strong modifier of this relationship (p for interaction<0.001): age<70 years, fully adjusted model HR = 3.52 (1.17–10.57) and age ≥70 years, HR = 0.80 (0.46–1.40). Respective HRs for all-cause mortality were 1.86 (1.03–3.32) and 0.73 (0.51–1.04).ConclusionsIn diabetic people aged 70 years and lower, central obesity was independently associated with increased cardiovascular mortality, independently of the negative effect of NT-proBNP. In contrast, no effect on 6-years survival was evident in diabetic people who have yet survived up to 70 years.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Effect of Age and NT-proBNP on the Association of Central Obesity with 6-Years Cardiovascular Mortality of Middle-Aged and Elderly Diabetic People: The Population-Based Casale Monferrato Study

et al. 2014

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“…1). The two-sample capture-recapture method allowed a completeness of ascertainment of 95% to be achieved [16,17]. All the participants were white.…”

Section: Methodsmentioning

confidence: 99%

Prediction of mortality and macrovascular complications in type 2 diabetes: validation of the UKPDS Outcomes Model in the Casale Monferrato Survey, Italy

et al. 2013

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Aims/hypothesis The United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model can be used to estimate the lifetime occurrence of major diabetes-related complications in order to calculate health economic outcomes. The aim of the study was to assess the performance of the model by comparing the predicted and observed mortality and the incidence of macrovascular complications in an Italian population-based cohort with type 2 diabetes. Methods We used data from the Casale Monferrato Survey, a cohort enrolled in 1988 and surveyed in 1991 (n=1,967) to assess the prevalence of cardiovascular risk factors. In 2000, a new survey included all the members of the original cohort who were still alive (n=860), and in addition all individuals identified with a new diagnosis of type 2 diabetes since 1993 (n=2,389). We compared the mortality predicted by the model for the 1991 survey over the subsequent 17-year period with the observed risk. The following outcomes were analysed in the 2000 survey: myocardial infarction (MI), other ischaemic heart disease, stroke, congestive heart failure (CHF) and amputation. Results For all-cause mortality, the predictions from the model at 5 and 10 years (23% and 47%, respectively) were identical to the observed risks. At 15 years, the risk of death was slightly overestimated (an estimate of 67% vs 64% observed, 95% CI 61%, 66%). The performance of the model was best for patients with a recent history of disease (duration <6 years). Among the complications, the predicted cumulative incidences of MI and CHF were very close to those observed. Conclusions/interpretation External validation is essential to assess the accuracy of simulation models. The UKPDS Outcomes Model satisfactorily predicted a set of actual incidences of mortality and complications in an Italian diabetes cohort up to a duration of approximately 12 years. The longer term performance of such models should be carefully evaluated.

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“…The diabetic cohort included 2315 people aged 45-74 years, residents in 2000 in the town of Casale Monferrato, in the north-west of Italy (93 477 inhabitants) [13,14]. Of them, centralized CRP measurement was available in 1518 (65% of this cohort).…”

Section: Methodsmentioning

confidence: 99%

What is the clinical usefulness of the metabolic syndrome? The Casale Monferrato study

Bruno¹,

Fornengo²,

Segre³

et al. 2009

Journal of Hypertension

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Changes over time in the prevalence and quality of care of type 2 diabetes in Italy: The Casale Monferrato Surveys, 1988 and 2000

Cited by 30 publications

References 30 publications

The Effect of Age and NT-proBNP on the Association of Central Obesity with 6-Years Cardiovascular Mortality of Middle-Aged and Elderly Diabetic People: The Population-Based Casale Monferrato Study

The Effect of Age and NT-proBNP on the Association of Central Obesity with 6-Years Cardiovascular Mortality of Middle-Aged and Elderly Diabetic People: The Population-Based Casale Monferrato Study

Prediction of mortality and macrovascular complications in type 2 diabetes: validation of the UKPDS Outcomes Model in the Casale Monferrato Survey, Italy

What is the clinical usefulness of the metabolic syndrome? The Casale Monferrato study

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