MedicalResearch.com Interview with:
Dr Abbas Dehghan PhD
Assistant Professor, Department of Epidemiology
Erasmus University Medical Centre
MedicalResearch.com: What is the background for this study?
Dr. Dehghan: Diabetes is an important health treat given its serious complications including cardiovascular disease, blindness, kidney failure, and lower-extremity amputations. Descriptive studies have so far either reported the prevalence of diabetes which is a snapshot of the percentage of people who have diabetes or the risk that people will develop diabetes in next 5 or 10 years. These estimates are not optimal since they overlook the risk of developing diabetes later in life. We calculated the lifetime risk of type 2 diabetes which is the risk that every person carries to develop type 2 diabetes up to end of his life. Moreover, we provided estimates for prediabetes, a high risk status that people experience before developing diabetes, and need for insulin therapy that might indicates severity of the disease.
MedicalResearch.com: What are the main findings?
Dr. Dehghan: Our data suggest that the lifetime risk of developing prediabetes for a normoglycemic individual aged 45 years is one in two, and one in three nondiabetic individuals aged 45 years will develop diabetes. Three-quarters of individuals with prediabetes at age 45 years will eventually progress to diabetes, and half of the patients with diabetes at the same age will start insulin treatment. Stratification by BMI showed that normoglycemic people with healthy weight at age 45 years had a significantly lower prediabetes lifetime risk compared with overweight and obese individuals. Stratification by waist circumference showed similar effects on lifetime risks for diabetes in individuals with prediabetes. Similarly, in individuals with diabetes, the lifetime risk for insulin use among patients with diabetes was higher with increasing BMI and waist circumference.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Dehghan: Our findings are of use for risk communication with patients. Both clinicians and patients prefer lifetime risk estimates, which measure the cumulative risk for developing a disease during the remainder of a person’s life, vs. 10- to 20-year risk estimates.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Dehghan: Our research may indicate the importance of using lifetime risk estimation in risk prediction models rather than 5 or 10 years risk estimates. Moreover, our data show that 19% of people with healthy weight are at risk of developing diabetes during their life which is a substantial percentage. This may indicate the importance of further research on diabetes in lean individuals and risk factors other than obesity.
Lifetime risk of developing impaired glucose metabolism and eventual progression from prediabetes to type 2 diabetes: a prospective cohort study
Ligthart, Symen et al.
The Lancet Diabetes & Endocrinology , Volume 4 , Issue 1 , 44 – 51DOI: http://dx.doi.org/10.1016/S2213-8587(15)00362-9
Dr Abbas Dehghan PhD (2016). One In Three Middle Age Patients Will Develop Diabetes