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Classifying diabetes according to the new WHO clinical stages
Abstract
Aims/hypothesis To test the usefulness of the new WHO criteria for clinical staging of diabetes in the characterization of 1977 diabetic patients. Methods The following clinical stages were used: patients on diet and/or oral antidiabetic agents 2 years after diagnosis were considered as non-insulin requiring (NIR; n = 711) and patients who required insulin therapy after 1 year as insulin requiring for control (IRC; n = 543). Patients who because of deteriorating hyperglycemia within 1 year required insulin therapy were considered as insulin requiring for survival (IRS; n = 743). Results The NIR patients had the highest age at onset (52 +/- 12 years; mean +/- SD), BMI (29.3 +/- 5.2 kg/m2) and C-peptide concentrations (median 0.98 nmol/l; interquartile range 0.72-1.31 nmol/l) but the lowest frequency of GAD antibodies (5.5%) compared to the IRC and IRS groups. The IRC group had a high age at onset (49 +/- 13 years), BMI (28.0 +/- 4.8 kg/m2), frequency of GAD antibodies (16.8%), intermediate C-peptide concentrations (0.56 nmol/l, interquartile range 0.28 +/- 0.94), and the highest prevalence of nephropathy (31.5%) and neuropathy (68.1%). The IRS group had the lowest age at onset (23 +/- 15 years), BMI (24.2 +/- 3.4 kg/m2), C-peptide concentrations (0.05 nmol/l, interquartile range below detection limit 0.01) and highest frequency of GAD antibodies (44.5%). Retinopathy was more common in IRS than in IRC patients (62.1 vs. 43.9%;p Conclusions The new WHO criteria seem to discrimin…
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Given strict HbA1c criteria for new-onset diabetes in the MHR and the requirement of physician diagnosis in NDR and Diabetes 2000, those classified as new-onset diabetes cases are unlikely to be misclassified.
“On the other hand, given the strict HbA1c criteria for new-onset diabetes in the MHR and the fact that the NDR and Diabetes 2000 registers require a physician diagnosis according to established diagnostic criteria,28, 29 those classified as new-onset diabetes cases in our study are unlikely to be misclassified.”
From Plasma Copeptin and the Risk of Diabetes Mellitus (2010) · cites this paper as [29]
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Metadata
- Authors
- Lindholm, E., Agardh, E., Tuomi, T., Groop, L., & Agardh, C.-D.
- Venue
- European Journal of Epidemiology
- Published
- 2001-11
- Volume
- 17
- Issue
- 11
- Pages
- 983-989
- ISSN
- 0393-2990 (ISSN-L)
- 1573-7284
- OpenAlex
- W1960743603
- Semantic Scholar
- 8f224af55ca98bc4f9a0d8adc3d36176ebada5c7
- Cited by
- 82
- References
- 13
- Citations by year
- 2024: 5 · 2023: 2 · 2022: 2 · 2021: 2 · 2020: 4 · 2019: 1 · 2018: 9 · 2017: 5 · 2016: 6 · 2015: 3 · 2014: 8 · 2013: 2 · 2012: 12
- FWCI
- 0.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- European Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- diabetes mellitus, WHO clinical stage, insulin requirement, glutamic acid decarboxylase antibodies, C-peptide, age of onset, body mass index, diabetic nephropathy, diabetic neuropathy, diabetic retinopathy, disease severity classification
- MeSH terms
- Aged, Autoantibodies, C-Peptide, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Glutamate Decarboxylase, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Insulin, Male, Middle Aged, Sweden, World Health Organization, Biomarkers, Guidelines as Topic, Disease Progression
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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