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HbA1c and Lower-Extremity Amputation Risk in Low-Income Patients With Diabetes
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| Zeitschriftentitel: | Diabetes Care |
|---|---|
| Personen und Körperschaften: | , , , , , , , , |
| In: | Diabetes Care, 36, 2013, 11, S. 3591-3598 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
American Diabetes Association
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| Schlagwörter: |
| author_facet |
Zhao, Wenhui Katzmarzyk, Peter T. Horswell, Ronald Wang, Yujie Johnson, Jolene Heymsfield, Steven B. Cefalu, William T. Ryan, Donna H. Hu, Gang Zhao, Wenhui Katzmarzyk, Peter T. Horswell, Ronald Wang, Yujie Johnson, Jolene Heymsfield, Steven B. Cefalu, William T. Ryan, Donna H. Hu, Gang |
|---|---|
| author |
Zhao, Wenhui Katzmarzyk, Peter T. Horswell, Ronald Wang, Yujie Johnson, Jolene Heymsfield, Steven B. Cefalu, William T. Ryan, Donna H. Hu, Gang |
| spellingShingle |
Zhao, Wenhui Katzmarzyk, Peter T. Horswell, Ronald Wang, Yujie Johnson, Jolene Heymsfield, Steven B. Cefalu, William T. Ryan, Donna H. Hu, Gang Diabetes Care HbA1c and Lower-Extremity Amputation Risk in Low-Income Patients With Diabetes Advanced and Specialized Nursing Endocrinology, Diabetes and Metabolism Internal Medicine |
| author_sort |
zhao, wenhui |
| spelling |
Zhao, Wenhui Katzmarzyk, Peter T. Horswell, Ronald Wang, Yujie Johnson, Jolene Heymsfield, Steven B. Cefalu, William T. Ryan, Donna H. Hu, Gang 0149-5992 1935-5548 American Diabetes Association Advanced and Specialized Nursing Endocrinology, Diabetes and Metabolism Internal Medicine http://dx.doi.org/10.2337/dc13-0437 <jats:sec> <jats:title>OBJECTIVE</jats:title> <jats:p>Diabetes confers a very high risk of lower-extremity amputation (LEA); however, few studies have assessed whether blood glucose control can reduce LEA risk among patients with diabetes, especially in practice settings where low-income patients predominate.</jats:p> </jats:sec> <jats:sec> <jats:title>RESEARCH DESIGN AND METHODS</jats:title> <jats:p>We performed a prospective cohort study (2000–2009) on patients with diabetes that included 19,808 African Americans and 15,560 whites. The cohort was followed though 31 May 2012. Cox proportional hazards regression models were used to estimate the association of HbA1c with LEA risk.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>During a mean follow-up of 6.83 years, 578 LEA incident cases were identified. The multivariable-adjusted hazard ratios of LEA associated with different levels of HbA1c at baseline (&lt;6.0% [reference group], 6.0–6.9, 7.0–7.9, 8.0–8.9, 9.0–9.9, and ≥10.0%) were 1.00, 1.73 (95% CI 1.07–2.80), 1.65 (0.99–2.77), 1.96 (1.14–3.36), 3.02 (1.81–5.04), and 3.30 (2.10–5.20) (P trend &lt;0.001) for African American patients with diabetes and 1.00, 1.16 (0.66–2.02), 2.28 (1.35–3.85), 2.38 (1.36–4.18), 2.99 (1.71–5.22), and 3.25 (1.98–5.33) (P trend &lt;0.001) for white patients with diabetes, respectively. The graded positive association of HbA1c during follow-up with LEA risk was observed among both African American and white patients with diabetes (all P trend &lt;0.001). With stratification by sex, age, smoking status, blood pressure, LDL cholesterol, BMI, use of glucose-lowering agents, and income, this graded association of HbA1c with LEA was still present.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>The current study conducted in a low-income population suggests a graded association between HbA1c and the risk of LEA among both African American and white patients with type 2 diabetes.</jats:p> </jats:sec> HbA1c and Lower-Extremity Amputation Risk in Low-Income Patients With Diabetes Diabetes Care |
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American Diabetes Association, 2013 |
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| title |
HbA1c and Lower-Extremity Amputation Risk in Low-Income Patients With Diabetes |
| title_unstemmed |
HbA1c and Lower-Extremity Amputation Risk in Low-Income Patients With Diabetes |
| title_full |
HbA1c and Lower-Extremity Amputation Risk in Low-Income Patients With Diabetes |
| title_fullStr |
HbA1c and Lower-Extremity Amputation Risk in Low-Income Patients With Diabetes |
| title_full_unstemmed |
HbA1c and Lower-Extremity Amputation Risk in Low-Income Patients With Diabetes |
| title_short |
HbA1c and Lower-Extremity Amputation Risk in Low-Income Patients With Diabetes |
| title_sort |
hba1c and lower-extremity amputation risk in low-income patients with diabetes |
| topic |
Advanced and Specialized Nursing Endocrinology, Diabetes and Metabolism Internal Medicine |
| url |
http://dx.doi.org/10.2337/dc13-0437 |
| publishDate |
2013 |
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3591-3598 |
| description |
<jats:sec>
<jats:title>OBJECTIVE</jats:title>
<jats:p>Diabetes confers a very high risk of lower-extremity amputation (LEA); however, few studies have assessed whether blood glucose control can reduce LEA risk among patients with diabetes, especially in practice settings where low-income patients predominate.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>RESEARCH DESIGN AND METHODS</jats:title>
<jats:p>We performed a prospective cohort study (2000–2009) on patients with diabetes that included 19,808 African Americans and 15,560 whites. The cohort was followed though 31 May 2012. Cox proportional hazards regression models were used to estimate the association of HbA1c with LEA risk.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>RESULTS</jats:title>
<jats:p>During a mean follow-up of 6.83 years, 578 LEA incident cases were identified. The multivariable-adjusted hazard ratios of LEA associated with different levels of HbA1c at baseline (&lt;6.0% [reference group], 6.0–6.9, 7.0–7.9, 8.0–8.9, 9.0–9.9, and ≥10.0%) were 1.00, 1.73 (95% CI 1.07–2.80), 1.65 (0.99–2.77), 1.96 (1.14–3.36), 3.02 (1.81–5.04), and 3.30 (2.10–5.20) (P trend &lt;0.001) for African American patients with diabetes and 1.00, 1.16 (0.66–2.02), 2.28 (1.35–3.85), 2.38 (1.36–4.18), 2.99 (1.71–5.22), and 3.25 (1.98–5.33) (P trend &lt;0.001) for white patients with diabetes, respectively. The graded positive association of HbA1c during follow-up with LEA risk was observed among both African American and white patients with diabetes (all P trend &lt;0.001). With stratification by sex, age, smoking status, blood pressure, LDL cholesterol, BMI, use of glucose-lowering agents, and income, this graded association of HbA1c with LEA was still present.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>CONCLUSIONS</jats:title>
<jats:p>The current study conducted in a low-income population suggests a graded association between HbA1c and the risk of LEA among both African American and white patients with type 2 diabetes.</jats:p>
</jats:sec> |
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| author | Zhao, Wenhui, Katzmarzyk, Peter T., Horswell, Ronald, Wang, Yujie, Johnson, Jolene, Heymsfield, Steven B., Cefalu, William T., Ryan, Donna H., Hu, Gang |
| author_facet | Zhao, Wenhui, Katzmarzyk, Peter T., Horswell, Ronald, Wang, Yujie, Johnson, Jolene, Heymsfield, Steven B., Cefalu, William T., Ryan, Donna H., Hu, Gang, Zhao, Wenhui, Katzmarzyk, Peter T., Horswell, Ronald, Wang, Yujie, Johnson, Jolene, Heymsfield, Steven B., Cefalu, William T., Ryan, Donna H., Hu, Gang |
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| description | <jats:sec> <jats:title>OBJECTIVE</jats:title> <jats:p>Diabetes confers a very high risk of lower-extremity amputation (LEA); however, few studies have assessed whether blood glucose control can reduce LEA risk among patients with diabetes, especially in practice settings where low-income patients predominate.</jats:p> </jats:sec> <jats:sec> <jats:title>RESEARCH DESIGN AND METHODS</jats:title> <jats:p>We performed a prospective cohort study (2000–2009) on patients with diabetes that included 19,808 African Americans and 15,560 whites. The cohort was followed though 31 May 2012. Cox proportional hazards regression models were used to estimate the association of HbA1c with LEA risk.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>During a mean follow-up of 6.83 years, 578 LEA incident cases were identified. The multivariable-adjusted hazard ratios of LEA associated with different levels of HbA1c at baseline (&lt;6.0% [reference group], 6.0–6.9, 7.0–7.9, 8.0–8.9, 9.0–9.9, and ≥10.0%) were 1.00, 1.73 (95% CI 1.07–2.80), 1.65 (0.99–2.77), 1.96 (1.14–3.36), 3.02 (1.81–5.04), and 3.30 (2.10–5.20) (P trend &lt;0.001) for African American patients with diabetes and 1.00, 1.16 (0.66–2.02), 2.28 (1.35–3.85), 2.38 (1.36–4.18), 2.99 (1.71–5.22), and 3.25 (1.98–5.33) (P trend &lt;0.001) for white patients with diabetes, respectively. The graded positive association of HbA1c during follow-up with LEA risk was observed among both African American and white patients with diabetes (all P trend &lt;0.001). With stratification by sex, age, smoking status, blood pressure, LDL cholesterol, BMI, use of glucose-lowering agents, and income, this graded association of HbA1c with LEA was still present.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>The current study conducted in a low-income population suggests a graded association between HbA1c and the risk of LEA among both African American and white patients with type 2 diabetes.</jats:p> </jats:sec> |
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| spelling | Zhao, Wenhui Katzmarzyk, Peter T. Horswell, Ronald Wang, Yujie Johnson, Jolene Heymsfield, Steven B. Cefalu, William T. Ryan, Donna H. Hu, Gang 0149-5992 1935-5548 American Diabetes Association Advanced and Specialized Nursing Endocrinology, Diabetes and Metabolism Internal Medicine http://dx.doi.org/10.2337/dc13-0437 <jats:sec> <jats:title>OBJECTIVE</jats:title> <jats:p>Diabetes confers a very high risk of lower-extremity amputation (LEA); however, few studies have assessed whether blood glucose control can reduce LEA risk among patients with diabetes, especially in practice settings where low-income patients predominate.</jats:p> </jats:sec> <jats:sec> <jats:title>RESEARCH DESIGN AND METHODS</jats:title> <jats:p>We performed a prospective cohort study (2000–2009) on patients with diabetes that included 19,808 African Americans and 15,560 whites. The cohort was followed though 31 May 2012. Cox proportional hazards regression models were used to estimate the association of HbA1c with LEA risk.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>During a mean follow-up of 6.83 years, 578 LEA incident cases were identified. The multivariable-adjusted hazard ratios of LEA associated with different levels of HbA1c at baseline (&lt;6.0% [reference group], 6.0–6.9, 7.0–7.9, 8.0–8.9, 9.0–9.9, and ≥10.0%) were 1.00, 1.73 (95% CI 1.07–2.80), 1.65 (0.99–2.77), 1.96 (1.14–3.36), 3.02 (1.81–5.04), and 3.30 (2.10–5.20) (P trend &lt;0.001) for African American patients with diabetes and 1.00, 1.16 (0.66–2.02), 2.28 (1.35–3.85), 2.38 (1.36–4.18), 2.99 (1.71–5.22), and 3.25 (1.98–5.33) (P trend &lt;0.001) for white patients with diabetes, respectively. The graded positive association of HbA1c during follow-up with LEA risk was observed among both African American and white patients with diabetes (all P trend &lt;0.001). With stratification by sex, age, smoking status, blood pressure, LDL cholesterol, BMI, use of glucose-lowering agents, and income, this graded association of HbA1c with LEA was still present.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>The current study conducted in a low-income population suggests a graded association between HbA1c and the risk of LEA among both African American and white patients with type 2 diabetes.</jats:p> </jats:sec> HbA1c and Lower-Extremity Amputation Risk in Low-Income Patients With Diabetes Diabetes Care |
| spellingShingle | Zhao, Wenhui, Katzmarzyk, Peter T., Horswell, Ronald, Wang, Yujie, Johnson, Jolene, Heymsfield, Steven B., Cefalu, William T., Ryan, Donna H., Hu, Gang, Diabetes Care, HbA1c and Lower-Extremity Amputation Risk in Low-Income Patients With Diabetes, Advanced and Specialized Nursing, Endocrinology, Diabetes and Metabolism, Internal Medicine |
| title | HbA1c and Lower-Extremity Amputation Risk in Low-Income Patients With Diabetes |
| title_full | HbA1c and Lower-Extremity Amputation Risk in Low-Income Patients With Diabetes |
| title_fullStr | HbA1c and Lower-Extremity Amputation Risk in Low-Income Patients With Diabetes |
| title_full_unstemmed | HbA1c and Lower-Extremity Amputation Risk in Low-Income Patients With Diabetes |
| title_short | HbA1c and Lower-Extremity Amputation Risk in Low-Income Patients With Diabetes |
| title_sort | hba1c and lower-extremity amputation risk in low-income patients with diabetes |
| title_unstemmed | HbA1c and Lower-Extremity Amputation Risk in Low-Income Patients With Diabetes |
| topic | Advanced and Specialized Nursing, Endocrinology, Diabetes and Metabolism, Internal Medicine |
| url | http://dx.doi.org/10.2337/dc13-0437 |