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Are the same clinical risk factors relevant for incident diabetes defined by treatment, fasting plasma glucose, and HbA1c?
Balkau B., Soulimane S., Lange C., Gautier A., Tichet J., Vol S.
Diabetes Care 34, 4 (2011) 957-9 - http://www.hal.inserm.fr/inserm-00739799
 (21346181) 
Are the same clinical risk factors relevant for incident diabetes defined by treatment, fasting plasma glucose, and HbA1c?
Beverley Balkau () 1, Soraya Soulimane1, Céline Lange1, Alain Gautier2, 3, Jean Tichet4, Sylviane Vol4, D.E.S.I.R. STUDY GROUP (Inter Regional Health Institute, IRSA, La Riche, F-37521 France) Collaboration(s)
1 :  CESP - Centre de recherche en épidémiologie et santé des populations
INSERM : U1018 – Université Paris XI - Paris Sud – Hôpital Paul Brousse – Assistance publique - Hôpitaux de Paris (AP-HP)
16 avenue Paul Vaillant Couturier 94807 Villejuif Cedex, France
France
2 :  Service d'endocrinologie diabétologie et nutrition [Rennes]
CHU Rennes – Hôpital Anne-de-Bretagne – Université de Rennes 1
35203 Rennes
France
3 :  GERHM - Groupe d'Etude de la Reproduction Chez l'Homme et les Mammiferes
INSERM : U625 – Université de Rennes 1 – IFR140 – IRSET
263, Avenue du Général Leclerc 35042 Rennes Cedex
France
4 :  IRSA - Institut inter Régional pour la SAnté
Centre de Prévention et de Santé Publique de Tours - La Riche
45 rue de la Parmentière 37 521 La Riche Cedex
France
Risk factors: fasting glucose or HbA1c diabetes
OBJECTIVE: To compare incidences and risk factors for diabetes using seven definitions, with combinations of pharmacological treatment, fasting plasma glucose (FPG) ≥7.0 mmol/L, and HbA(1c) ≥6.5%. RESEARCH DESIGN AND METHODS: Participants aged 30-65 years from the Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR) cohort were followed for 9 years. RESULTS: More men had incident diabetes as defined by FPG ≥7.0 mmol/L and/or treatment than by HbA(1c) ≥6.5% and/or treatment: 7.5% (140/1,867) and 5.3% (99/1,874), respectively (P < 0.009); for women incidences were similar: 3.2% (63/1,958) and 3.4% (66/1,954). Known risk factors predicted diabetes for almost all definitions. Among those with incident diabetes by FPG alone versus HbA(1c) alone, there were more men (78 vs. 35%), case patients were 8 years younger, and fewer were alcohol abstainers (12 vs. 35%) (all P < 0.005). A diabetes risk score discriminated well between those with and without incident diabetes for all definitions. CONCLUSIONS: In men, FPG definitions yielded more incident cases of diabetes than HbA(1c) definitions, in contrast with women. An FPG-derived risk score remained relevant for HbA(1c)-defined diabetes.
Sciences du Vivant/Santé publique et épidémiologie
Anglais
1935-5548

Articles dans des revues avec comité de lecture
10.2337/dc10-1581
Diabetes Care (Diabetes Care)
Publisher American Diabetes Association
ISSN 0149-5992 (eISSN : 0149-5992)
internationale
04/2011
23/02/2011
34
4
957-9

epidemiology – fasting plasma glucose – HbA1c – incidence – risk factors – type 2 diabetes
Adult – Aged – Blood Glucose – Diabetes Mellitus – Type 2 – Female – Hemoglobin A – Glycosylated – Humans – Male – Middle Aged – Odds Ratio – Risk Factors – Adult
The D.E.S.I.R. study has been supported by INSERM contracts with CNAMTS, Lilly, Novartis Pharma and Sanofi-Aventis; by INSERM (Réseaux en Santé Publique, Interactions entre les déterminants de la santé), Cohortes Santé TGIR, the Association Diabète Risque Vasculaire, the Fédération Française de Cardiologie, La Fondation de France, ALFEDIAM, ONIVINS, Société francophone du diabète , Ardix Medical, Bayer Diagnostics, Becton Dickinson, Cardionics, Merck Santé, Novo Nordisk, Pierre Fabre, Roche, Topcon.
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Balkau_D_Care_risk_scores_22_11_2010.doc(168.5 KB)
Balkau_Diabetes_Care_2011_Figure.doc(38 KB)
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Balkau_D_Care_risk_scores_22_11_2010.pdf(251.3 KB)
Balkau_Diabetes_Care_2011_Figure.pdf(73.3 KB)