Prevalence of diagnosed type 1 and type 2 diabetes among US adults in 2016 and 2017: population based study

Xu, Guoqing; Liu, Buyun; Sun, Yangbo; Du, Yang; Snetselaar, Linda; Hu, Frank B.; Bao, Wei

doi:10.1136/bmj.k1497

Cited by 414 publications

(303 citation statements)

References 41 publications

Supporting

Mentioning

281

Contrasting

Unclassified

Order By: Relevance

“…Although the number of women diagnosed with type I diabetes was small, this is reflective of the general population which is expected to have very low type I diabetes prevalence (0.6%, 95%CI ¼ 0.5, 0.8) among individuals 45 years. Specifically, they reported that the weighted prevalence (%, 95%CI) for type I diabetes were 0.5 (0.3, 0.6), 0.6 (0.4, 0.7), and 0.6 (0.5, 0.8) in 20e44 aged, 45e64 aged, and 65 aged adults in the United States [34].…”

Section: Discussionmentioning

confidence: 99%

Long-term diabetes risk among endometrial cancer survivors in a population-based cohort study

Kim

Park

Chen

et al. 2020

Gynecologic Oncology

View full text Add to dashboard Cite

h i g h l i g h t sEndometrial cancer survivors in all BMI groups had an increased risk of diabetes. 29.5% of endometrial cancer patients were diagnosed with diabetes after diagnosis of endometrial cancer. Obesity was the most important risk factor for type II diabetes among endometrial cancer survivors. Overall, endometrial cancer survivors had a twofold higher risk of type II diabetes compared to the general population. Gynecologic Oncology 156 (2020) 185e193 Conclusions: In conclusion, endometrial cancer survivors had a higher risk of diabetes than women in the general population. These results suggest that long term monitoring for diabetes is indicated for endometrial cancer survivors.

show abstract

Section: Discussionmentioning

confidence: 99%

Long-term diabetes risk among endometrial cancer survivors in a population-based cohort study

Kim

Park

Chen

et al. 2020

Gynecologic Oncology

View full text Add to dashboard Cite

show abstract

“…Although it was not possible to accurately distinguish between type 1 and type 2 diabetes, more than 98% of those classified with diabetes had at least one code indicating type 2 diabetes. Also, the prevalence of type 1 diabetes among older adults is less than 4%, and prior studies of veterans have documented low prevalence of true type 1 diabetes because this diagnosis disqualifies military service …”

Section: Discussionmentioning

confidence: 99%

“…Also, the prevalence of type 1 diabetes among older adults is less than 4%, and prior studies of veterans have documented low prevalence of true type 1 diabetes because this diagnosis disqualifies military service. (27,28) Our study has several strengths. To our knowledge, this is the largest cohort study among older men with diabetes investigating the association and interactions of glycemic control and treatment regimen on incident fracture risk.…”

Section: Journal Of Bone and Mineral Researchmentioning

confidence: 96%

Glycemic Control and Insulin Treatment Alter Fracture Risk in Older Men With Type 2 Diabetes Mellitus

Lee

Sloane

Pieper

et al. 2019

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

Diabetes mellitus among older men has been associated with increased bone mineral density but paradoxically increased fracture risk. Given the interactions among medication treatment, glycemic control, and diabetes‐associated comorbidities, the relative effects of each factor remains unclear. This retrospective study includes 652,901 male veterans aged ≥65 years with diabetes and baseline hemoglobin A1c (HbA1c) value. All subjects received primary care in the Veterans Health Administration (VHA) from 2000 to 2010. Administrative data included ICD9 diagnoses and pharmacy records and was linked to Medicare fee‐for‐service data. Hazard ratios (HR) for any clinical fracture and hip fracture were calculated using competing risk hazards models, adjusted for fracture risk factors including age, race/ethnicity, body mass index (BMI), alcohol and tobacco use, rheumatoid arthritis, corticosteroid use, as well as diabetes‐related comorbidities including cardiovascular disease, chronic kidney disease, and peripheral neuropathy. HbA1c <6.5% was associated with a higher risk of any clinical fracture (HR = 1.08, 95% confidence interval [CI] 1.06–1.11) compared with the reference HbA1c of 7.5% to 8.5%. Fracture risk was not increased among those with A1c ≥8.5%, nor among those with A1c 6.5% to 7.5%. Use of insulin was independently associated with greater risk of fracture (HR = 1.10, 95% CI 1.07–1.12). There was a significant interaction between insulin use and HbA1c level, (p < 0.001), such that those using insulin with HbA1c <6.5% had HR = 1.23 and those with HbA1c 6.5% to 7.5% had HR = 1.15. Metformin use was associated with decreased fracture risk (HR = 0.88, 95% CI 0.87–0.90). We conclude that among older men with diabetes, those with HbA1c lower than 6.5% are at increased risk for any clinical and hip fracture. Insulin use is associated with higher fracture risk, especially among those with tight glycemic control. Our findings demonstrate the importance of the treatment regimen and avoiding hypoglycemia for fracture prevention in older men with diabetes. © 2019 American Society for Bone and Mineral Research.

show abstract

“…Compelling observational epidemiological studies have shown that NAFLD is highly correlated with metabolic disorders such as type 2 diabetes (T2D) [3][4][5] and obesity 1,6,7 . All three diseases together affect over 50% of the U.S. population [8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

Mendelian Randomization Analysis Dissects the Relationship between NAFLD, T2D, and Obesity and Provides Implications to Precision Medicine

Liu

Zhang

Graham

et al. 2019

Preprint

View full text Add to dashboard Cite

Background:Non-alcoholic fatty liver disease (NAFLD) is epidemiologically correlated with both type 2 diabetes (T2D) and obesity. However, the causal inter-relationships among the three diseases have not been completely investigated. Aim:We aim to explore the causal relationships among the three diseases. Design and methods:We performed a genome-wide association study (GWAS) on fatty liver disease in ~400,000 UK BioBank samples. Using this data as well as the largest-to-date publicly available summarylevel GWAS data, we performed a two-sample bidirectional Mendelian Randomization (MR) analysis. This analysis tested the causal inter-relationship between NAFLD, T2D, and obesity, as well as the association between genetically driven NAFLD (with two well-established SNPs at the PNPLA3 and TM6SF2 loci) and glycemic and lipidemic traits, respectively. Transgenic mice expressing the human PNPLA3 I148I (TghPNPLA3-I148I) and PNPLA3 I148M (TghPNPLA3-I148M) isoforms were used to further validate the causal effects. Results:We found that genetically instrumented hepatic steatosis significantly increased the risk for T2D (OR=1.3, 95% CI: [1.2, 1.4], p=8.3e-14) but not the intermediate glycemic phenotypes at the Bonferroni-adjusted level of significance (p<0.002). There was a moderate, but significant causal association between genetically driven hepatic steatosis and decreased risk for BMI (β=-0.027 SD, 95%CI: [-0.043, -0.01], p=1.3e-4), but an increased risk for WHRadjBMI (Waist-Hip Ratio adjusted for BMI) (β=0.039 SD, 95%CI: [0.023, 0.054], p=8.2e-7), as well as a decreased level for total cholesterol (β=-0.084 SD, 95%CI [-0.13, -0.036], p=6.8e-4), but not triglycerides (β=0.02 SD, 95%CI [-0.023, 0.062], p=0.36). The reverse MR analyses suggested that genetically driven T2D (OR=1.1, 95% CI: [1.0, 1.2], p=1.7e-3), BMI (OR=2.3, 95% CI: [2.0, 2.7], p=1.4e-25) and WHRadjBMI (OR=1.5, 95% CI: [1.3, 1.8], p=1.1e-6) causally increase the NAFLD risk. In the animal study, as compared to the TghPNPLA3-I148I controls, the TghPNPLA3-I148M mice developed higher fasting glucose level and reduced glucose clearance. Meanwhile, the TghPNPLA3-I148M mice demonstrated a reduced body weight, increased central to peripheral fat ratio, decreased circulating total cholesterol as compared to the TghPNPLA3-I148I controls. Conclusion:This large-scale bidirectional MR study suggests that lifelong, genetically driven NAFLD is a causal risk factor for T2D (hence potentially a "NAFLD-driven T2D" subtype) and central obesity (or "NAFLD-driven obesity" subtype), but protects against overall obesity; while genetically driven T2D, obesity, and central obesity also causally increase the risk of NAFLD, hence a "metabolic NAFLD". This causal relationship revealed new insights into disease subtypes and provided novel hypotheses for precision treatment or prevention for the three diseases.

show abstract

Prevalence of diagnosed type 1 and type 2 diabetes among US adults in 2016 and 2017: population based study

Cited by 414 publications

References 41 publications

Long-term diabetes risk among endometrial cancer survivors in a population-based cohort study

Long-term diabetes risk among endometrial cancer survivors in a population-based cohort study

Glycemic Control and Insulin Treatment Alter Fracture Risk in Older Men With Type 2 Diabetes Mellitus

Mendelian Randomization Analysis Dissects the Relationship between NAFLD, T2D, and Obesity and Provides Implications to Precision Medicine

Contact Info

Product

Resources

About