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Simple Tool Stratifies Mortality Risk in Type 2 Diabetes
Medscape Medical News ^ | May 13, 2013 | Marlene Busko

Posted on 05/13/2013 11:51:28 AM PDT by Stoat

Simple Tool Stratifies Mortality Risk in Type 2 Diabetes

Marlene Busko May 13, 2013

 

Researchers have created an online mortality-risk calculator for patients with type 2 diabetes, which stratifies patients into low, medium, or high risk of dying from any cause within 2 years.

By plugging in values for 9 readily available patient characteristics — age, body mass index (BMI), diastolic blood pressure, LDL cholesterol, triglycerides, HDL cholesterol, urine albumin-to-creatinine ratio, antihypertensive treatment, and insulin therapy — a physician can quickly determine whether a patient has a high risk for death.

"The novelty and the importance of this study is that we provide physicians with a simple, free, and validated Web-based risk [calculator] able to predict mortality in their type 2 diabetic patients," lead author Salvatore de Cosmo, MD, from Casa Sollievo della Sofferenza, in San Giovanni Rotondo, and senior author Vincenzo Trischitta, MD, from Sapienza University, in Rome, Italy, told Medscape Medical News in an email.

"We do believe that the implementation of our model may help prioritize the use of available resources for targeting aggressive preventive and treatment strategies in a subset of very high-risk individuals."

The study is published online May 1 in Diabetes Care.

A Few Simple Measures, a Helpful Risk Predictor

Having diabetes doubles a person's risk of dying, the authors write, and it would be useful for physicians to be able to identify which diabetic patients are at greatest risk. The few previously proposed models to predict mortality in diabetes were not validated in an independent cohort and did not use recently available statistical tools, they explain.

The researchers analyzed data from 2 prospective cohorts of patients with type 2 diabetes. They developed their model based on data from 679 patients in the Gargano Mortality Study, who were followed for 7.4 years. Risk predictors were added one by one, until there was no further improvement in prediction of death.

They validated their model using data from 936 patients in the Foggia Mortality trial, who were followed for 4.5 years.

About 2.4% of the patients in both studies died each year.

Elevated age, urine-albumin-to-creatinine ratio, and LDL cholesterol, as well as taking insulin therapy or being on antihypertensive treatment all predicted higher mortality risk. Elevated HDL, BMI, and diastolic blood pressure predicted lower mortality risk, however, and triglyceride levels also showed a trend toward an inverse correlation.

"We want to stress that our interest was not a matter of pathophysiology but simply that of unraveling good-enough markers and methodological approaches to predict all-cause mortality," they commented.

The overall mortality risk score ran from 0 to 1, with a mean of 0.53. The researchers partitioned this into 3 risk categories: low (risk score 0.67 or less), intermediate (0.68 to 0.79), and high (0.80 or more). At 2 years, compared with the patients with low risk scores, those with medium scores were 7 times more likely to have died, and those with high scores were 24 times more likely to have died.

"To the best of our knowledge, this is the first study developing a well-performing model for this event that was validated in a second independent sample," the authors write. "Our model is parsimonious, with a few simple-to-measure variables needed to make it very informative," they add.

The calculator will help physicians identify which patients should be monitored more closely and which ones are candidates for more aggressive strategies to treat modifiable risk factors, Drs. De Cosmo and Trischitta note.

However, it should also be tested in other populations of diabetes patients in order to address its generalizability, they point out, since the studies to develop and validate it were conducted in primarily white, Italian populations.

The authors have reported no relevant financial relationships.

Diabetes Care . Published online May 1, 2013. Abstract


TOPICS: Health/Medicine; Science
KEYWORDS: deathpanels; diabetes; diabetescalculator; health; healthcare; medicine; mortalitycalculator; obamacare; socializedmedicine; type2diabetes; zerocare
"We do believe that the implementation of our model may help prioritize the use of available resources for targeting aggressive preventive and treatment strategies in a subset of very high-risk individuals."

Stoat Translation:  This will provide a simple, numerical mechanism for socialist bureaucrat bean-counters to deny certain patients access to more effective and more expensive treatment options under any Socialist healthcare system.

 

Gargano Mortality Risk Score 

 

Risk Score Calculator

 

1 posted on 05/13/2013 11:51:28 AM PDT by Stoat
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To: Stoat

Says I died last year.


2 posted on 05/13/2013 11:55:39 AM PDT by Gadsden1st
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To: Gadsden1st
Says I died last year.

That's the way I want to go . . . not even realize it.

3 posted on 05/13/2013 12:22:36 PM PDT by Misterioso (It don't mean a thing if it ain't got that swing - Duke Ellington)
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To: Gadsden1st

I’m at LOW RISK SCORE ~ .46 ~ low cholesterol levels ~


4 posted on 05/13/2013 12:38:40 PM PDT by muawiyah
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To: Stoat

Bump to read later...


5 posted on 05/13/2013 12:56:20 PM PDT by pgkdan (Some taglines never go away....)
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To: muawiyah

I got the same score as you, based on the lab report from 2 months ago. I’ve put the calculator into my bookmarks.


6 posted on 05/13/2013 12:58:42 PM PDT by T-Bird45 (It feels like the seventies, and it shouldn't.)
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To: Stoat

Doctor: “Here’s your score, sir. (no need to bend over)”

Office Administrator: “Here’s your (exorbitant) co-pay bill. Oh, and here’s your new (higher) insurance rate.

Have a nice day.”

(please bend over)


7 posted on 05/13/2013 1:10:17 PM PDT by logi_cal869
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To: Stoat

Thanks for posting this. It was reassuring. I’m low risk for mortality in the next two years.

On the other hand, it means I probably should get back to my chores now.


8 posted on 05/13/2013 1:27:36 PM PDT by married21
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To: Stoat

Bumping for diabetics I may know or be married to


9 posted on 05/13/2013 1:28:29 PM PDT by EDINVA
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To: Stoat; neverdem
BTTT
10 posted on 05/13/2013 1:40:35 PM PDT by texas booster (Join FreeRepublic's Folding@Home team (Team # 36120) Cure Alzheimer's!)
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To: EDINVA

My wife thinks she’s married to a diabetic. Some days she’s right, other times not so much. My blood sugar is 120 average & yes I need to lose weight.

Face it, she’s right. Time to get off the dime.


11 posted on 05/13/2013 2:21:27 PM PDT by elcid1970 ("The Second Amendment is more important than Islam.")
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To: Stoat

*


12 posted on 05/13/2013 2:29:48 PM PDT by JDoutrider
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To: Stoat

how do you double a persons risk to die?

I was informed that everyones risk to die was 100%

Silly me.


13 posted on 05/13/2013 2:33:11 PM PDT by esoxmagnum (The rats have been trained to pull the D voting lever to get their little food pellet)
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To: Stoat

Bump for later


14 posted on 05/13/2013 2:35:50 PM PDT by Senator_Blutarski
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To: elcid1970

please, don’t fool around with it. My sainted spouse claimed for years he was “borderline” diabetic. Until one night the blood sugar got out of control, raised his blood pressure thru the roof, ending up in a stroke. Scary stuff. He’s since gotten very good on taking his meds. If you DO need to lose weight, try that before you start the meds because I am not sure there is any going back once you start. Good luck!


15 posted on 05/13/2013 2:45:41 PM PDT by EDINVA
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To: texas booster

Thanks for the ping.


16 posted on 05/13/2013 11:21:27 PM PDT by neverdem (Register pressure cookers! /s)
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To: elcid1970

When my blood sugar drops to 120, I can barely function


17 posted on 05/14/2013 4:33:00 AM PDT by bert ((K.E. N.P. N.C. +12 .....History is a process, not an event)
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