Declining Trends of Cardiovascular-Renal Complications and Mortality in Type 2 Diabetes: The Hong Kong Diabetes Database
Nationwide studies on secular trends of diabetes complications are not available in Asia. We examined changes in risk factor control and incidence of complications from diabetes and death in a large longitudinal cohort of Chinese adults with type 2 diabetes in Hong Kong. Between 1 January 2000 and 3...
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| Veröffentlicht in: | Diabetes care 2017-07, Vol.40 (7), p.928-935 |
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| creator | Luk, Andrea O Y Hui, Eric M T Sin, Ming-Chuen Yeung, Chun-Yip Chow, Wing-Sun Ho, Andrew Y Y Hung, Hin-Fai Kan, Eva Ng, Chiu-Ming So, Wing-Yee Yeung, Chi-Kin Chan, Kin-Sang Chan, Kin-Wah Chan, Pang-Fai Siu, Shing-Chung Tiu, Sau-Cheung Yeung, Vincent T F Chan, Juliana C N Chan, Frank W K Cheung, Clement Cheung, Ngai-Tseung Ho, Siu-Tung Lam, Karen S L Yu, Linda W L Chao, David Lau, Ip-Tim |
| description | Nationwide studies on secular trends of diabetes complications are not available in Asia. We examined changes in risk factor control and incidence of complications from diabetes and death in a large longitudinal cohort of Chinese adults with type 2 diabetes in Hong Kong.
Between 1 January 2000 and 31 December 2012, 338,908 Chinese adults with type 2 diabetes underwent metabolic and complication assessment in 16 diabetes centers operated by Hong Kong Hospital Authority that provided care to a large majority of diagnosed patients. Patients were followed for incident acute myocardial infarction (AMI), stroke, end-stage renal disease (ESRD), and death until 31 December 2012. Risk factor levels between enrollment periods were compared. Incidence of clinical events, stratified by diabetes duration, was examined over time.
Incidence of complications from diabetes and death declined over the observation period in patients at varying disease duration. Among the high-risk group with diabetes for at least 15 years, crude incidence of AMI decreased from 8.7 to 5.8, stroke from 13.5 to 10.1, ESRD from 25.8 to 22.5, and death from 29.0 to 26.6 per 1,000 person-year between the periods 2000 to 2002 and 2010 to 2012. Improvements in levels of metabolic risk factors were detected. Proportion of patients achieving HbA |
| doi_str_mv | 10.2337/dc16-2354 |
| format | Article |
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Between 1 January 2000 and 31 December 2012, 338,908 Chinese adults with type 2 diabetes underwent metabolic and complication assessment in 16 diabetes centers operated by Hong Kong Hospital Authority that provided care to a large majority of diagnosed patients. Patients were followed for incident acute myocardial infarction (AMI), stroke, end-stage renal disease (ESRD), and death until 31 December 2012. Risk factor levels between enrollment periods were compared. Incidence of clinical events, stratified by diabetes duration, was examined over time.
Incidence of complications from diabetes and death declined over the observation period in patients at varying disease duration. Among the high-risk group with diabetes for at least 15 years, crude incidence of AMI decreased from 8.7 to 5.8, stroke from 13.5 to 10.1, ESRD from 25.8 to 22.5, and death from 29.0 to 26.6 per 1,000 person-year between the periods 2000 to 2002 and 2010 to 2012. Improvements in levels of metabolic risk factors were detected. Proportion of patients achieving HbA
<7.0% (53 mmol/mol) was increased from 32.9 to 50.0%, blood pressure ≤130/80 mmHg from 24.7 to 30.7%, and LDL cholesterol <2.6 mmol/L from 25.8 to 38.1%.
From this territory-wide Hong Kong Diabetes Database, we observed decreases in incidence of cardiovascular-renal complications and death and corresponding improvements in risk factor control over a 13-year period.</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/dc16-2354</identifier><identifier>PMID: 28490423</identifier><language>eng</language><publisher>United States: American Diabetes Association</publisher><subject>Adults ; Aged ; Asian Continental Ancestry Group ; Asian people ; Biomarkers - blood ; Blood pressure ; Cardiovascular disease ; Cardiovascular diseases ; Cerebral infarction ; Cholesterol ; Cholesterol - blood ; Cohort Studies ; Complications ; Databases, Factual ; Death ; Diabetes ; Diabetes Complications - complications ; Diabetes Complications - epidemiology ; Diabetes mellitus ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - mortality ; End-stage renal disease ; Female ; Follow-Up Studies ; Glycated Hemoglobin A ; Health risks ; Hong Kong - epidemiology ; Humans ; Hypoglycemic Agents - therapeutic use ; Incidence ; Kidney diseases ; Kidney Failure, Chronic - complications ; Kidney Failure, Chronic - epidemiology ; Kidney transplantation ; Longitudinal Studies ; Low density lipoprotein ; Male ; Middle Aged ; Mortality ; Myocardial infarction ; Myocardial Infarction - complications ; Myocardial Infarction - epidemiology ; Patients ; Prospective Studies ; Research design ; Risk analysis ; Risk Factors ; Risk groups ; Risk management ; Stroke ; Stroke - complications ; Stroke - epidemiology ; Trends</subject><ispartof>Diabetes care, 2017-07, Vol.40 (7), p.928-935</ispartof><rights>2017 by the American Diabetes Association.</rights><rights>Copyright American Diabetes Association Jul 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c348t-616d6d7772933b4ef8b0ccab5c0991dd67ca31ebdef46390de6c9ecd1ecde3483</citedby><cites>FETCH-LOGICAL-c348t-616d6d7772933b4ef8b0ccab5c0991dd67ca31ebdef46390de6c9ecd1ecde3483</cites><orcidid>0000-0002-5244-6069</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28490423$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Luk, Andrea O Y</creatorcontrib><creatorcontrib>Hui, Eric M T</creatorcontrib><creatorcontrib>Sin, Ming-Chuen</creatorcontrib><creatorcontrib>Yeung, Chun-Yip</creatorcontrib><creatorcontrib>Chow, Wing-Sun</creatorcontrib><creatorcontrib>Ho, Andrew Y Y</creatorcontrib><creatorcontrib>Hung, Hin-Fai</creatorcontrib><creatorcontrib>Kan, Eva</creatorcontrib><creatorcontrib>Ng, Chiu-Ming</creatorcontrib><creatorcontrib>So, Wing-Yee</creatorcontrib><creatorcontrib>Yeung, Chi-Kin</creatorcontrib><creatorcontrib>Chan, Kin-Sang</creatorcontrib><creatorcontrib>Chan, Kin-Wah</creatorcontrib><creatorcontrib>Chan, Pang-Fai</creatorcontrib><creatorcontrib>Siu, Shing-Chung</creatorcontrib><creatorcontrib>Tiu, Sau-Cheung</creatorcontrib><creatorcontrib>Yeung, Vincent T F</creatorcontrib><creatorcontrib>Chan, Juliana C N</creatorcontrib><creatorcontrib>Chan, Frank W K</creatorcontrib><creatorcontrib>Cheung, Clement</creatorcontrib><creatorcontrib>Cheung, Ngai-Tseung</creatorcontrib><creatorcontrib>Ho, Siu-Tung</creatorcontrib><creatorcontrib>Lam, Karen S L</creatorcontrib><creatorcontrib>Yu, Linda W L</creatorcontrib><creatorcontrib>Chao, David</creatorcontrib><creatorcontrib>Lau, Ip-Tim</creatorcontrib><title>Declining Trends of Cardiovascular-Renal Complications and Mortality in Type 2 Diabetes: The Hong Kong Diabetes Database</title><title>Diabetes care</title><addtitle>Diabetes Care</addtitle><description>Nationwide studies on secular trends of diabetes complications are not available in Asia. We examined changes in risk factor control and incidence of complications from diabetes and death in a large longitudinal cohort of Chinese adults with type 2 diabetes in Hong Kong.
Between 1 January 2000 and 31 December 2012, 338,908 Chinese adults with type 2 diabetes underwent metabolic and complication assessment in 16 diabetes centers operated by Hong Kong Hospital Authority that provided care to a large majority of diagnosed patients. Patients were followed for incident acute myocardial infarction (AMI), stroke, end-stage renal disease (ESRD), and death until 31 December 2012. Risk factor levels between enrollment periods were compared. Incidence of clinical events, stratified by diabetes duration, was examined over time.
Incidence of complications from diabetes and death declined over the observation period in patients at varying disease duration. Among the high-risk group with diabetes for at least 15 years, crude incidence of AMI decreased from 8.7 to 5.8, stroke from 13.5 to 10.1, ESRD from 25.8 to 22.5, and death from 29.0 to 26.6 per 1,000 person-year between the periods 2000 to 2002 and 2010 to 2012. Improvements in levels of metabolic risk factors were detected. Proportion of patients achieving HbA
<7.0% (53 mmol/mol) was increased from 32.9 to 50.0%, blood pressure ≤130/80 mmHg from 24.7 to 30.7%, and LDL cholesterol <2.6 mmol/L from 25.8 to 38.1%.
From this territory-wide Hong Kong Diabetes Database, we observed decreases in incidence of cardiovascular-renal complications and death and corresponding improvements in risk factor control over a 13-year period.</description><subject>Adults</subject><subject>Aged</subject><subject>Asian Continental Ancestry Group</subject><subject>Asian people</subject><subject>Biomarkers - blood</subject><subject>Blood pressure</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Cerebral infarction</subject><subject>Cholesterol</subject><subject>Cholesterol - blood</subject><subject>Cohort Studies</subject><subject>Complications</subject><subject>Databases, Factual</subject><subject>Death</subject><subject>Diabetes</subject><subject>Diabetes Complications - complications</subject><subject>Diabetes Complications - epidemiology</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - mortality</subject><subject>End-stage renal disease</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glycated Hemoglobin A</subject><subject>Health risks</subject><subject>Hong Kong - epidemiology</subject><subject>Humans</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Incidence</subject><subject>Kidney diseases</subject><subject>Kidney Failure, Chronic - complications</subject><subject>Kidney Failure, Chronic - epidemiology</subject><subject>Kidney transplantation</subject><subject>Longitudinal Studies</subject><subject>Low density lipoprotein</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Myocardial infarction</subject><subject>Myocardial Infarction - complications</subject><subject>Myocardial Infarction - epidemiology</subject><subject>Patients</subject><subject>Prospective Studies</subject><subject>Research design</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Risk groups</subject><subject>Risk management</subject><subject>Stroke</subject><subject>Stroke - complications</subject><subject>Stroke - epidemiology</subject><subject>Trends</subject><issn>0149-5992</issn><issn>1935-5548</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkU1LAzEQhoMotn4c_AMS8KKH1XztbuJNWrViRZB6XrLJrKZsNzXZFfvv3dLWg4eZgeHhgZkXoTNKrhnn-Y01NEsYT8UeGlLF0yRNhdxHQ0KFSlKl2AAdxTgnhAgh5SEaMCkUEYwP0c8YTO0a13zgWYDGRuwrPNLBOv-to-lqHZI3aHSNR36xrJ3RrfNNxLqx-MWHVteuXWHX4NlqCZjhsdMltBBv8ewT8MT33ud12-3xWLe61BFO0EGl6win23mM3h_uZ6NJMn19fBrdTRPDhWyTjGY2s3meM8V5KaCSJTFGl6khSlFrs9xoTqG0UImMK2IhMwqMpX1Bb-DH6HLjXQb_1UFsi4WLBupaN-C7WFCpckkyRkiPXvxD574L_e09pZgSXAqZ9tTVhjLBxxigKpbBLXRYFZQU6ziKdRzFOo6ePd8au3IB9o_c_Z__AvCohWQ</recordid><startdate>201707</startdate><enddate>201707</enddate><creator>Luk, Andrea O Y</creator><creator>Hui, Eric M T</creator><creator>Sin, Ming-Chuen</creator><creator>Yeung, Chun-Yip</creator><creator>Chow, Wing-Sun</creator><creator>Ho, Andrew Y Y</creator><creator>Hung, Hin-Fai</creator><creator>Kan, Eva</creator><creator>Ng, Chiu-Ming</creator><creator>So, Wing-Yee</creator><creator>Yeung, Chi-Kin</creator><creator>Chan, Kin-Sang</creator><creator>Chan, Kin-Wah</creator><creator>Chan, Pang-Fai</creator><creator>Siu, Shing-Chung</creator><creator>Tiu, Sau-Cheung</creator><creator>Yeung, Vincent T F</creator><creator>Chan, Juliana C N</creator><creator>Chan, Frank W K</creator><creator>Cheung, Clement</creator><creator>Cheung, Ngai-Tseung</creator><creator>Ho, Siu-Tung</creator><creator>Lam, Karen S L</creator><creator>Yu, Linda W L</creator><creator>Chao, David</creator><creator>Lau, Ip-Tim</creator><general>American Diabetes Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5244-6069</orcidid></search><sort><creationdate>201707</creationdate><title>Declining Trends of Cardiovascular-Renal Complications and Mortality in Type 2 Diabetes: The Hong Kong Diabetes Database</title><author>Luk, Andrea O Y ; Hui, Eric M T ; Sin, Ming-Chuen ; Yeung, Chun-Yip ; Chow, Wing-Sun ; Ho, Andrew Y Y ; Hung, Hin-Fai ; Kan, Eva ; Ng, Chiu-Ming ; So, Wing-Yee ; Yeung, Chi-Kin ; Chan, Kin-Sang ; Chan, Kin-Wah ; Chan, Pang-Fai ; Siu, Shing-Chung ; Tiu, Sau-Cheung ; Yeung, Vincent T F ; Chan, Juliana C N ; Chan, Frank W K ; Cheung, Clement ; Cheung, Ngai-Tseung ; Ho, Siu-Tung ; Lam, Karen S L ; Yu, Linda W L ; Chao, David ; Lau, Ip-Tim</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c348t-616d6d7772933b4ef8b0ccab5c0991dd67ca31ebdef46390de6c9ecd1ecde3483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adults</topic><topic>Aged</topic><topic>Asian Continental Ancestry Group</topic><topic>Asian people</topic><topic>Biomarkers - 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Academic</collection><jtitle>Diabetes care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Luk, Andrea O Y</au><au>Hui, Eric M T</au><au>Sin, Ming-Chuen</au><au>Yeung, Chun-Yip</au><au>Chow, Wing-Sun</au><au>Ho, Andrew Y Y</au><au>Hung, Hin-Fai</au><au>Kan, Eva</au><au>Ng, Chiu-Ming</au><au>So, Wing-Yee</au><au>Yeung, Chi-Kin</au><au>Chan, Kin-Sang</au><au>Chan, Kin-Wah</au><au>Chan, Pang-Fai</au><au>Siu, Shing-Chung</au><au>Tiu, Sau-Cheung</au><au>Yeung, Vincent T F</au><au>Chan, Juliana C N</au><au>Chan, Frank W K</au><au>Cheung, Clement</au><au>Cheung, Ngai-Tseung</au><au>Ho, Siu-Tung</au><au>Lam, Karen S L</au><au>Yu, Linda W L</au><au>Chao, David</au><au>Lau, Ip-Tim</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Declining Trends of Cardiovascular-Renal Complications and Mortality in Type 2 Diabetes: The Hong Kong Diabetes Database</atitle><jtitle>Diabetes care</jtitle><addtitle>Diabetes Care</addtitle><date>2017-07</date><risdate>2017</risdate><volume>40</volume><issue>7</issue><spage>928</spage><epage>935</epage><pages>928-935</pages><issn>0149-5992</issn><eissn>1935-5548</eissn><abstract>Nationwide studies on secular trends of diabetes complications are not available in Asia. We examined changes in risk factor control and incidence of complications from diabetes and death in a large longitudinal cohort of Chinese adults with type 2 diabetes in Hong Kong.
Between 1 January 2000 and 31 December 2012, 338,908 Chinese adults with type 2 diabetes underwent metabolic and complication assessment in 16 diabetes centers operated by Hong Kong Hospital Authority that provided care to a large majority of diagnosed patients. Patients were followed for incident acute myocardial infarction (AMI), stroke, end-stage renal disease (ESRD), and death until 31 December 2012. Risk factor levels between enrollment periods were compared. Incidence of clinical events, stratified by diabetes duration, was examined over time.
Incidence of complications from diabetes and death declined over the observation period in patients at varying disease duration. Among the high-risk group with diabetes for at least 15 years, crude incidence of AMI decreased from 8.7 to 5.8, stroke from 13.5 to 10.1, ESRD from 25.8 to 22.5, and death from 29.0 to 26.6 per 1,000 person-year between the periods 2000 to 2002 and 2010 to 2012. Improvements in levels of metabolic risk factors were detected. Proportion of patients achieving HbA
<7.0% (53 mmol/mol) was increased from 32.9 to 50.0%, blood pressure ≤130/80 mmHg from 24.7 to 30.7%, and LDL cholesterol <2.6 mmol/L from 25.8 to 38.1%.
From this territory-wide Hong Kong Diabetes Database, we observed decreases in incidence of cardiovascular-renal complications and death and corresponding improvements in risk factor control over a 13-year period.</abstract><cop>United States</cop><pub>American Diabetes Association</pub><pmid>28490423</pmid><doi>10.2337/dc16-2354</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-5244-6069</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Diabetes care, 2017-07, Vol.40 (7), p.928-935 |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals |
| subjects | Adults Aged Asian Continental Ancestry Group Asian people Biomarkers - blood Blood pressure Cardiovascular disease Cardiovascular diseases Cerebral infarction Cholesterol Cholesterol - blood Cohort Studies Complications Databases, Factual Death Diabetes Diabetes Complications - complications Diabetes Complications - epidemiology Diabetes mellitus Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - mortality End-stage renal disease Female Follow-Up Studies Glycated Hemoglobin A Health risks Hong Kong - epidemiology Humans Hypoglycemic Agents - therapeutic use Incidence Kidney diseases Kidney Failure, Chronic - complications Kidney Failure, Chronic - epidemiology Kidney transplantation Longitudinal Studies Low density lipoprotein Male Middle Aged Mortality Myocardial infarction Myocardial Infarction - complications Myocardial Infarction - epidemiology Patients Prospective Studies Research design Risk analysis Risk Factors Risk groups Risk management Stroke Stroke - complications Stroke - epidemiology Trends |
| title | Declining Trends of Cardiovascular-Renal Complications and Mortality in Type 2 Diabetes: The Hong Kong Diabetes Database |
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