AIMS/HYPOTHESIS: The aim of this study was to determine the frequency of undiagnosed glucose abnormalities and the burden of cardiovascular disease (CVD) risk among south Asians and white Europeans attending a systematic screening programme for type 2 diabetes (ADDITION-Leicester) and to estimate the achievable risk reduction in individuals identified with glucose disorders. METHODS: Random samples of individuals (n = 66,320) from 20 general practices were invited for a 75 g OGTT and CVD risk assessment. Ten-year CVD risk among screen-detected people with diabetes or impaired glucose regulation (IGR) (impaired fasting glycaemia and/or impaired glucose tolerance [IGT]) was computed using the Framingham-based ETHRISK engine and achievable risk reduction was predicted using relative reductions for treatments extracted from published trials. RESULTS: A total of 6,041 participants (48% male, 22% south Asian) aged 40-75 years inclusive were included. Undiagnosed glucose disorders occurred more frequently in south Asians than white Europeans; age and sex adjusted odds ratios were 1.74 (95% CI 1.42-2.13) and 2.30 (95% CI 1.68-3.16) for IGT and diabetes respectively. Prevalence of any undetected glucose disorder was 17.5% in the whole cohort. Adjusted 10-year risk was similar in screen-detected people with IGR and diabetes (18.3% vs 21.6%), and was higher in south Asians across the glucose spectrum. Absolute CVD risk reductions of up to 13% in those with screen-detected type 2 diabetes and 6% in IGR are achievable using existing cardioprotective therapies. CONCLUSIONS/ INTERPRETATION: Population screening with an OGTT identifies a significant burden of modifiable CVD risk, especially within south Asian groups. Strategies enticing this population to consider screening programmes are urgently needed as significant risk reduction is possible once a glucose abnormality is identified. TRIAL REGISTRATION: ClinicalTrials.gov NCT00318032. FUNDING: The project is funded for support and treatment costs by NHS Department of Health Support for Science and project grants.
AIMS/HYPOTHESIS: The aim of this study was to determine the frequency of undiagnosed glucose abnormalities and the burden of cardiovascular disease (CVD) risk among south Asians and white Europeans attending a systematic screening programme for type 2 diabetes (ADDITION-Leicester) and to estimate the achievable risk reduction in individuals identified with glucose disorders. METHODS: Random samples of individuals (n = 66,320) from 20 general practices were invited for a 75 g OGTT and CVD risk assessment. Ten-year CVD risk among screen-detected people with diabetes or impaired glucose regulation (IGR) (impaired fasting glycaemia and/or impaired glucose tolerance [IGT]) was computed using the Framingham-based ETHRISK engine and achievable risk reduction was predicted using relative reductions for treatments extracted from published trials. RESULTS: A total of 6,041 participants (48% male, 22% south Asian) aged 40-75 years inclusive were included. Undiagnosed glucose disorders occurred more frequently in south Asians than white Europeans; age and sex adjusted odds ratios were 1.74 (95% CI 1.42-2.13) and 2.30 (95% CI 1.68-3.16) for IGT and diabetes respectively. Prevalence of any undetected glucose disorder was 17.5% in the whole cohort. Adjusted 10-year risk was similar in screen-detected people with IGR and diabetes (18.3% vs 21.6%), and was higher in south Asians across the glucose spectrum. Absolute CVD risk reductions of up to 13% in those with screen-detected type 2 diabetes and 6% in IGR are achievable using existing cardioprotective therapies. CONCLUSIONS/ INTERPRETATION: Population screening with an OGTT identifies a significant burden of modifiable CVD risk, especially within south Asian groups. Strategies enticing this population to consider screening programmes are urgently needed as significant risk reduction is possible once a glucose abnormality is identified. TRIAL REGISTRATION: ClinicalTrials.gov NCT00318032. FUNDING: The project is funded for support and treatment costs by NHS Department of Health Support for Science and project grants.
Authors: Helen M Colhoun; D John Betteridge; Paul N Durrington; Graham A Hitman; H Andrew W Neil; Shona J Livingstone; Margaret J Thomason; Michael I Mackness; Valentine Charlton-Menys; John H Fuller Journal: Lancet Date: 2004 Aug 21-27 Impact factor: 79.321
Authors: J B Echouffo-Tcheugui; L A Sargeant; A T Prevost; K M Williams; R S Barling; R Butler; T Fanshawe; A L Kinmonth; N J Wareham; S J Griffin Journal: Diabet Med Date: 2008-12 Impact factor: 4.359
Authors: N Waugh; G Scotland; P McNamee; M Gillett; A Brennan; E Goyder; R Williams; A John Journal: Health Technol Assess Date: 2007-05 Impact factor: 4.014
Authors: Colin Baigent; Lisa Blackwell; Rory Collins; Jonathan Emberson; Jon Godwin; Richard Peto; Julie Buring; Charles Hennekens; Patricia Kearney; Tom Meade; Carlo Patrono; Maria Carla Roncaglioni; Alberto Zanchetti Journal: Lancet Date: 2009-05-30 Impact factor: 79.321
Authors: A Sandbaek; S J Griffin; G Rutten; M Davies; R Stolk; K Khunti; K Borch-Johnsen; N J Wareham; T Lauritzen Journal: Diabetologia Date: 2008-04-29 Impact factor: 10.122
Authors: Karlijn A C Meeks; Deivisson Freitas-Da-Silva; Adebowale Adeyemo; Erik J A J Beune; Pietro A Modesti; Karien Stronks; Mohammad H Zafarmand; Charles Agyemang Journal: Intern Emerg Med Date: 2015-09-14 Impact factor: 3.397
Authors: Maria I Creatore; Gillian L Booth; Douglas G Manuel; Rahim Moineddin; Richard H Glazier Journal: Diabetes Care Date: 2012-02-22 Impact factor: 19.112
Authors: Everlina M A Vlaar; Irene G M van Valkengoed; Vera Nierkens; Mary Nicolaou; Barend J C Middelkoop; Karien Stronks Journal: BMC Public Health Date: 2012-05-23 Impact factor: 3.295
Authors: Anne Douglas; Raj S Bhopal; Ruby Bhopal; John F Forbes; Jason M R Gill; John McKnight; Gordon Murray; Naveed Sattar; Anu Sharma; Sunita Wallia; Sarah Wild; Aziz Sheikh Journal: BMJ Open Date: 2013-02-22 Impact factor: 2.692
Authors: Neil Pearce; Shah Ebrahim; Martin McKee; Peter Lamptey; Mauricio L Barreto; Don Matheson; Helen Walls; Sunia Foliaki; J Jaime Miranda; Oyun Chimeddamba; Luis Garcia-Marcos; Andy Haines; Paolo Vineis Journal: J Public Health Policy Date: 2015-09-17 Impact factor: 3.526
Authors: L J Gray; K Khunti; C Edwardson; S Goldby; J Henson; D H Morris; D Sheppard; D Webb; S Williams; T Yates; M J Davies Journal: Diabetologia Date: 2012-09-22 Impact factor: 10.122
Authors: Kamlesh Khunti; Danielle H Morris; Claire L Weston; Laura J Gray; David R Webb; Melanie J Davies Journal: PLoS One Date: 2013-01-30 Impact factor: 3.240