Table 2.
Characteristics of people with type 2 diabetes in each cohort, along with incident microvascular and cardiovascular outcome definitions and timing
| Outcome | MESA (n = 1,555) | JHS (n = 1,746) |
|---|---|---|
| Prevalent diabetes (diagnosed at baseline exam or prior), count | 859 | 1,152 |
| Incident diabetes (diagnosed during course of study follow-up), count | 696 | 594 |
| On oral diabetes agents, count | 661 | 806 |
| On insulin, count | 120 | Not specified |
| Time to diabetes diagnosis, median (range) in days among those diagnosed during course of study (after baseline exam) | 1,653 (319, 4,078) | 2,230 (1,331, 4,403) |
| Incident microalbuminuria, count (new microalbuminuria not present on baseline laboratories or first laboratories after diabetes diagnosis) | 291 | 176 |
| Time to incident microalbuminuria, median (range) in days | 721 (395, 4,003) | 1,847 (878, 5,982) |
| Incident macroalbuminuria, count (new macroalbuminuria not present on baseline laboratories or first laboratories after diabetes diagnosis) | 92 | 77 |
| Time to incident macroalbuminuria, median (range) in days | 1,126 (414, 3,780) | 2,386 (1,125, 4,964) |
| Incident renal failure/ESRD, count (new renal failure/ESRD not present on baseline laboratories or first laboratories after diabetes diagnosis) | 13 | 27 |
| Time to incident renal failure/ESRD, median (range) in days | 1,808 (1,038, 3,787) | 1,848 (1,700, 2,346) |
| Incident retinopathy, count (new retinopathy not present on exam 2 photos but present on exam 5 photos) | 34 | 94 |
| Time to incident retinopathy, median (range) in days | 2,837 (2,450, 3,259) | 2,817 (1,909, 4,083) |
| Incident MI (fatal or nonfatal), count (new MI among people without history of MI on baseline exam or first exam after diabetes diagnosis) | 92 | 151 |
| Time to incident MI, median (range) in days | 3,645 (29, 5,275) | 1,786 (9, 4,385) |
| Incident stroke (fatal or nonfatal), count (new stroke among people without history of stroke on baseline exam or first exam after diabetes diagnosis) | 89 | 142 |
| Time to incident stroke, median (range) in days | 3,636 (7, 5,275) | 1,542 (17, 4,039) |
| Incident CHF, count (new CHF among people without history of CHF on baseline exam or first exam after diabetes diagnosis) | 117 | 161 |
| Time to incident CHF, median (range) in days | 3,598 (29, 5,275) | 3,896 (35, 4,844) |
| Incident cardiovascular death, count | 88 | 64 |
| Time to incident cardiovascular death, median (range) in days | 2,764 (29, 5,045) | 1,806 (9, 4,444) |
| Incident all-cause mortality, count | 323 | 795 |
| Time to incident all-cause mortality, median (range) in days | 4,224 (29, 5,275) | 3,944 (77, 5,209) |
Time to an incident event is defined as number of days from diabetes diagnosis or baseline examination, whichever comes later, to the point at which the incident event was recorded. Time to event was censored at 10 years to correspond to the 10-year risk prediction from the RECODe equations. Urine albumin and creatinine were measured by nephelometry and the rate Jaffe reaction, respectively (40,41). Serum creatinine was measured in MESA using rate reflectance spectrophotometry using thin-film adaptation of the creatinine amidinohydrolase method on a Vitros analyzer calibrated to the Cleveland Clinic (42), and in JHS using a multipoint enzymatic spectrophotometric assay on a Vitros analyzer (43) with calibration against a National Institute of Standards and Technology standard (44). Retinopathy was evaluated by dilated, bilateral, seven-standard field fundus photographs including macular stereoscopic pairs, scored contemporaneously by two independent, masked ophthalmologist investigators with the ETDRS (23), including notation of focal laser treatment scars. Differences in diagnosis were arbitrated by a third masked ophthalmologist investigator and/or by joint review by the ophthalmologist investigators. Participants with another ocular disease that precluded photograph grading were excluded (25,45). CHF in JHS was defined by 1) a discharge diagnosis of ICD-9 code 428 and/or underlying cause of death I50, 2) radiographic findings consistent with CHF or increased venous pressure or dilated ventricle/left ventricular function <40% by echo/multiple gated acquisition scan, or 3) autopsy finding of pulmonary edema/CHF (46). CHF in MESA was defined by 1) CHF diagnosed by a physician and patient receiving medical treatment for CHF, 2) pulmonary edema/congestion seen on a chest radiograph, and 3) dilated ventricle or poor left ventricular systolic function by echocardiography or ventriculography or evidence of left ventricular diastolic dysfunction by echocardiography (47).