The prevalence of diabetes mellitus and related variables—A population study in Sudbury, Massachusetts

O’Sullivan, John B.; Williams, Robert F.; McDonald, Glen W.

doi:10.1016/0021-9681(67)90084-7

Cited by 28 publications

(9 citation statements)

References 15 publications

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“…Adjustment for age or obesity was considered adequate when direct standardization, regression analysis, or an equivalent method was used to calculate an effect measure adjusted for the potential confounding factor. Twelve studies found no association between childbearing experience and prevalence of diabetes mellitus or glucose intolerance but had not been adequately adjusted for age or obesity (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). When adequate adjustment was made for age and obesity together or age or obesity alone, no study found no association.…”

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confidence: 99%

Effects of Childbearing on Glucose Tolerance and NIDDM Prevalence

Boyko

Alderman²,

Keane³

et al. 1990

Diabetes Care

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The goal of this study was to estimate the effects of childbearing on subsequent glucose tolerance and non-insulin-dependent diabetes mellitus (NIDDM) prevalence. A sample of subjects from 64 different locations in the United States were recruited for inclusion in the Second National Health and Nutrition Examination Survey. A complex survey design was used to select a probability sample of subjects from each location. A total of 4577 women were recruited, of whom 3057 underwent clinical and laboratory evaluation for the presence of diabetes mellitus. Women were classified as to their glucose tolerance based on the results of an oral glucose tolerance test or previous physician diagnosis of diabetes mellitus combined with current use of hypoglycemic medication. Childbearing was defined as number of live births experienced by each woman at the time of the interview. Fasting plasma glucose increased linearly with increasing number of live births (coefficient 0.009, 95% confidence interval [CI] 0.006-0.012), as did the 2-h value (coefficient 0.015, 95% CI 0.009-0.021). Adjustment for age, body mass index (BMI), education, and income substantially reduced the magnitude of the association between childbearing and either plasma glucose measurement. When the prevalence of NIDDM in relation to childbearing was examined with logistic regression analysis, a significant linear increase in diabetes prevalence was seen with increasing number of live births (relative prevalence of NIDDM, 1 birth vs. 0 = 1.73, 95% CI 1.39-2.15), but adjustment for age, BMI, education, and income greatly reduced the magnitude of this association (relative prevalence of NIDDM, 1 birth vs. 0 = 1.07, 95% CI 0.98-1.17).(ABSTRACT TRUNCATED AT 250 WORDS)

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confidence: 99%

Effects of Childbearing on Glucose Tolerance and NIDDM Prevalence

Boyko

Alderman²,

Keane³

et al. 1990

Diabetes Care

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“…Prevalence figures for other diseases were used to derive samples of adults with and without prior cerebral infarction, 13 samples with and without diabetes, 14 and samples with and without coronary artery disease. 13 Analysis The samples obtained were used for calculation of relative risk point estimates and the associated 95 per cent logit confidence intervals.…”

Section: Controlsmentioning

confidence: 99%

Hypertension as a risk factor for spontaneous intracerebral hemorrhage.

Brott¹,

Thalinger

Hertzberg

1986

Stroke

333

134

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SUMMARY To better define the etiologic importance of hypertension for spontaneous intracerebral hemorrhage, hospital records were studied for all patients sustaining intracerebral hemorrhage during 1982 in the Cincinnati metropolitan area. Hypertension pre-dating the hemorrhage was present in 45% (69 of 154), as determined by history. A more inclusive definition of hypertension, combining those with a positive history with those found to have left ventricular hypertrophy by electrocardiogram or cardiomegaly by chest radiography, applied in 56% (87 of 154). The cases were compared to controls with and without hypertension derived from the NHANESII study of blood pressure (n = 16,204) to determine relative risk. For the presence of hypertension by history, the relative risk of intracerebral hemorrhage was 3.9 (95% confidence interval, 2.7 to 5.7). For the inclusive definition of hypertension, the relative risk was 5.4 (3.7 to 7.9). Relative risk was also determined for hypertension in blacks ( = 4.4), age > 70 ( = 7), prior cerebral infarction ( = 22), and diabetes ( = 3).We conclude that the term "hypertensive hemorrhage" should be used very selectively, particularly in whites, and propose that hypertension be viewed as one of several important risk factors for spontaneous intracerebral hemorrhage. Stroke Vol 17, No 6, 1986 THE TERM HYPERTENSIVE INTRACEREBRAL HEMORRHAGE is firmly imbedded in the medical literature.'" 3 When the characteristic high density lesion is seen in the computed tomographic scan (CT) critical differential diagnosis in the setting of acute stroke is too often truncated. Hypertension is quickly assumed to be causal, if present on the admission exam or if detected by history.We have been impressed at the bedside that an adequate history of hypertension is often lacking in patients with spontaneous intracerebral hemorrhage. When an adequate history for hypertension is established, other disorders of potential etiologic importance may be identified but are seldom given serious consideration. In prior studies of intracerebral hemorrhage, the blood pressure measurements (BP) were often those obtained during the acute event, 4 ' 5 or they were not provided. 6 Potential risk factors such as prior cerebral infarction or diabetes mellitus, were infrequently documented. 7 In 2 large studies of intracerebral hemorrhage in which criteria for the definition of hypertension were carefully specified, the results differed sharply regarding the importance of hypertension in pathogenesis. 89 A prospective epidemiologic study of intracerebral hemorrhage and potential risk factors is impractical. A ten-year study would require follow-up of approximately one million subjects to obtain 100 or more index cases. A longer study would require fewer subFrom the

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“…8 A review of the highlights of that study will provide information that bears on the quality of the contrasting prevalence rates that follow. These rates are, of course, derived from both a numerator (the diabetic subjects) and a denominator (the population).…”

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confidence: 99%

“…Confirmation resulted in several categories of certainty, as published, and 11 of the 64 subjects with stated diabetes (17.2%) were excluded from the final prevalence figure on the basis that their original diagnosis did not meet our criteria and their study data were completely normal. 8 Methods employed to assess potential bias in the results are outlined in Table 3. First, the OGTT was offered to a 5% random sample of the population to monitor the screening effect of the adopted diagnostic routine.…”

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confidence: 99%

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Prevalence and Course of Diabetes Modified by Fasting Blood Glucose Levels: Implications for Diagnostic Criteria

O’Sullivan

1979

Diabetes Care

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Data from the epidemiologic survey in Sudbury, Massachusetts, demonstrate that the prevalence of new cases of diabetes, based on the USPHS criteria for the standard 3-h oral glucose tolerance test as originally published, was 0.7%. If a fasting blood sugar greater than or equal to 110 mg/dl had been required for those USPH diagnoses, the prevalence would have fallen to 0.28%. Further, if a peak serum insulin level of less than or greater than 60 microM/ml had been required, the original prevalence rate would have dropped to 0.02%. Data from a prospeh criteria for diabetes indicate by life table analyses that 41% show further deterioration of carbohydrate control over the first 13 yr of the study when the fasting blood sugar was less than 110 mg/dl in the initial diagnostic test and 82% when the fasting blood sugar was greater than or equal to 110 mg/dl. The relationship of fasting blood glucose to later decompensation proved to be a continuous one without evidence of a threshold effect. The implications of both of these studies for diagnostic criteria, particularly recent proposals, is discussed.

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The prevalence of diabetes mellitus and related variables—A population study in Sudbury, Massachusetts

Cited by 28 publications

References 15 publications

Effects of Childbearing on Glucose Tolerance and NIDDM Prevalence

Effects of Childbearing on Glucose Tolerance and NIDDM Prevalence

Hypertension as a risk factor for spontaneous intracerebral hemorrhage.

Prevalence and Course of Diabetes Modified by Fasting Blood Glucose Levels: Implications for Diagnostic Criteria

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