UKPDS58: modeling glucose exposure as a risk factor for photocoagulation in type 2 diabetes
UKPDS58: modeling glucose exposure as a risk factor for photocoagulation in type 2 diabetes
In type 2 diabetes, the risk of retinopathy, and of retinal photocoagulation, rises with time after diagnosis of diabetes. In this paper, mathematical modeling shows that this ageing effect is attributable to the rise in glycemia with time since diagnosis of diabetes. Mathematical models were fitted to data from 3648 patients from the UK Prospective Diabetes Study (UKPDS). A proportional hazards model, in which time and glycemia measured by HbA1c are independent risk factors for photocoagulation, was compared to a model in which time does not contribute except through a measure of cumulative glucose exposure. Since likelihood ratio tests cannot be applied to non-nested models, graphical methods were used to compare the two models. The glucose exposure model was able to fit variation in survival with time at least as well as the proportional hazards model. The proportional hazards model, however, seriously underestimates the differences in two groups of different mean HbA1c. We conclude that duration of diabetes and HbA1c level better predict risk for photocoagulation when treated as two components of cumulative glucose exposure, than when treated as independent risk factors.
Age, Duration of diabetes, Glucose exposure, Modeling, Retinal photocoagulation
371-376
Stevens, Richard J.
9a5e134d-81ce-45cb-bd07-cf07cbcc93e9
Stratton, Irene M.
772f25b9-23c0-4240-a3f6-1e76b03b172f
Holman, Rury R.
336fb2f7-edb5-4d65-a7b0-465111cbd047
Stevens, Richard J.
9a5e134d-81ce-45cb-bd07-cf07cbcc93e9
Stratton, Irene M.
772f25b9-23c0-4240-a3f6-1e76b03b172f
Holman, Rury R.
336fb2f7-edb5-4d65-a7b0-465111cbd047
Stevens, Richard J., Stratton, Irene M. and Holman, Rury R.
(2002)
UKPDS58: modeling glucose exposure as a risk factor for photocoagulation in type 2 diabetes.
Journal of Diabetes and its Complications, 16 (6), .
(doi:10.1016/S1056-8727(02)00161-7).
Abstract
In type 2 diabetes, the risk of retinopathy, and of retinal photocoagulation, rises with time after diagnosis of diabetes. In this paper, mathematical modeling shows that this ageing effect is attributable to the rise in glycemia with time since diagnosis of diabetes. Mathematical models were fitted to data from 3648 patients from the UK Prospective Diabetes Study (UKPDS). A proportional hazards model, in which time and glycemia measured by HbA1c are independent risk factors for photocoagulation, was compared to a model in which time does not contribute except through a measure of cumulative glucose exposure. Since likelihood ratio tests cannot be applied to non-nested models, graphical methods were used to compare the two models. The glucose exposure model was able to fit variation in survival with time at least as well as the proportional hazards model. The proportional hazards model, however, seriously underestimates the differences in two groups of different mean HbA1c. We conclude that duration of diabetes and HbA1c level better predict risk for photocoagulation when treated as two components of cumulative glucose exposure, than when treated as independent risk factors.
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Accepted/In Press date: 28 December 2001
e-pub ahead of print date: 4 December 2002
Additional Information:
Funding Information:
The major grants for this study were from The National Eye Institute and The National Institute of Digestive, Diabetes and Kidney Disease in the National Institutes of Health, USA (grant 3 U10 EY07049), the UK Medical Research Council, British Diabetic Association, the UK Department of Health, The British Heart Foundation, Novo-Nordisk, Bayer, Bristol Myers Squibb, Hoechst, Lilly, Lipha and Farmitalia Carlo Erba. R.S. was supported by a Wellcome Trust fellowship (grant 054470/Z/98/Z/DG/NOS/FH).
Keywords:
Age, Duration of diabetes, Glucose exposure, Modeling, Retinal photocoagulation
Identifiers
Local EPrints ID: 487026
URI: http://eprints.soton.ac.uk/id/eprint/487026
ISSN: 1056-8727
PURE UUID: a9a5a7ef-e0af-4b9d-a674-19ed11c3e7d4
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Date deposited: 09 Feb 2024 17:47
Last modified: 18 Mar 2024 04:01
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Author:
Richard J. Stevens
Author:
Irene M. Stratton
Author:
Rury R. Holman
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