Macrovascular and Other Complications Of Type 2 Diabetes Mellitus

National Institute Of Diabetes And Digestive And Kidney Diseases

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Abstract

We follow a population-based cohort of Pima Indians who are invited every two years to participate in a research examinination. The methods for this longitudinal study are described in detail in Project Numbers Z01 DK069097 and Z01 DK069000. Electrocardiograms are obtained and serum total cholesterol, HDL cholesterol, and triglycerides are measured at each of these examinations. Participants with amputations are identified and the level of amputation is recorded. A death registry is maintained and underlying causes of death are determined by review of clinical records, autopsy reports and death certificates. Terminology and codes of the International Classification of Disease, Ninth Revision (ICD-9), are used to classify causes of death. [unreadable] [unreadable] In the past year, we found that the association of IHD with impaired glucose regulation was due primarily to factors other than hyperglycemia per se. Although impaired glucose regulation was associated with abnormal insulin secretion and action and predicted diabetes, it was not an independent predictor of mortality except in those who subsequently developed diabetes.[unreadable] [unreadable] In the coming year, we will characterize, among other things, the impact of heart rate and prolonged QT interval on mortality. Changes in management of diabetes will be examined to determine whether improvements in health services are reflected by improvements in blood pressure, glycemic, and lipid control. [unreadable] [unreadable] The Look AHEAD clinical trial of weight loss to prevent complications of type 2 diabetes has completed at least two years of observation on all participants. The study met its feasibility criteria of adequate weight loss and fitness change after two years.