print_label | resize_label

In type 2 diabetes…

The risks of uncontrolled blood glucose

Hyperglycemia may lead to increased risk of serious complications1

 

Incidence Complications for Patients With and Without Diabetes*

Incidence complications for patients with and without diabetesIncidence complications for patients with and without diabetesIncidence complications for patients with and without diabetes
*According to 2010 National Health Interview Survey (NHIS) statistics in adults aged ≥20 years or older with diagnosed T1D or T2D. The NHIS is a multistage probability survey that samples an average of 57,000 adults per year to estimate the health of the US population, the prevalence and incidence of disease, the extent of disability, and the use of health care services.

T1D=type 1 diabetes; T2D=type 2 diabetes. Adapted from Gregg EW et al. N Engl J Med. 2014;370:1514-1523.

 

According to recent national surveys, diabetes was associated with an increased risk for several complications. The number of events/10,000 noted below are reflective of data from adults in 2010:

  • Lower-Extremity Amputation: 28.4 for patients with diabetes, 2.7 for those without diabetes
  • End-Stage Renal Disease: 20.0 for patients with diabetes, 3.3 for those without diabetes
  • Acute Myocardial Infarction: 45.5 for patients with diabetes, 25.8 for those without diabetes
  • Stroke: 52.9 for patients with diabetes, 34.3 for those without diabetes

 

Several micro- and macrovascular complications are associated with elevated A1C1-3

  • According to data from a national survey in 2010, the relative risk of lower-extremity amputation was 10.5 compared with healthy controls1

  • CDC data for 2005-2008 showed that, of adults with diabetes aged 40 years or older, 4.2 million (28.5%) had diabetic retinopathy2

    • 655,000 (4.4%) of these patients had advanced diabetic retinopathy, with conditions such as clinically significant macular edema and proliferative diabetic retinopathy2

 

Risk of Complications by A1C Level3,4

Risk of complications by A1C levelRisk of complications by A1C levelRisk of complications by A1C level
  • In the UKPDS 35 study, 4585 patients who had an A1C measured 3 months after being diagnosed with diabetes were included in the analysis of incidence rates4
    • Of these patients, 3642 had complete data and were included in the relative risk analysis. Rates were adjusted using the Poisson regression model adjusted for male sex, white ethnic group, age at diagnosis 50-54 years, and duration of diabetes 7.5-12.5 years4
    • Follow-up was calculated from the end of the initial period of dietary treatment to the first occurrence of complication, loss to follow-up, death from another cause, or end of the study. The median follow-up time for all-cause mortality was 10.4 years4
 

Reduced risk of complications with early intensive glycemic control5

 

Proportion of Patients in UKPDS With Microvascular Disease

Proportion of patients in UKPDS with microvascular diseaseProportion of patients in UKPDS with microvascular diseaseProportion of patients in UKPDS with microvascular disease
  • Significant risk reduction for microvascular disease was maintained in the 10-year follow-up UKPDS study, despite early loss of between-group differences in glycemic control5
 

CDC=Centers for Disease Control and Prevention; UKPDS=United Kingdom Prospective Diabetes Study.

References:

  1. Gregg EW, Li Y, Wang J, et al. Changes in diabetes-related complications in the United States, 1990–2010. N Engl J Med. 2014;370:1514-1523.

  2. Centers for Disease Control and Prevention, Division of Diabetes Translation. A snapshot of diabetes in the United States. Accessed April 10, 2015.

  3. Benhalima K, Standl E, Mathieu C. The importance of glycemic control: how low should we go with HbA1c? Start early, go safe, go low. J Diabetes Complications. 2011;25;202-207.

  4. Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321:405-412.

  5. Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HA. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008;359:1577-1589.