Table 4.
Adjusted Hazard Ratios and 95% CIs for Major Clinical Outcomes, by Baseline Diabetes Status at ARIC Study Visit 2 (1990–1992)*
| Events/Participants, n/N | Hazard Ratio (95% CI) | ||
|---|---|---|---|
|
| |||
| Model 1† | Model 2‡ | ||
| Incident diagnosed diabetes | |||
|
| |||
| No diabetes | 2830/11 224 | 1.00 (reference) | 1.00 (reference) |
|
| |||
| Unconfirmed undiagnosed diabetes | 400/595 | 5.75 (5.16–6.40)§ | 4.32 (3.87–4.82)§ |
|
| |||
| Confirmed undiagnosed diabetes | 343/380 | 25.00 (22.10–28.28)§ | 15.90 (13.99–18.07)§ |
|
| |||
| Chronic kidney disease | |||
| No diabetes | 2653/11 108 | 1.00 (reference) | 1.00 (reference) |
|
| |||
| Unconfirmed undiagnosed diabetes | 188/582 | 1.55 (1.33–1.80) | 1.24 (1.07–1.44) |
|
| |||
| Confirmed undiagnosed diabetes | 134/373 | 1.80 (1.51–2.14) | 1.51 (1.26–1.80) |
|
| |||
| Diagnosed diabetes | 456/1017 | 2.91 (2.63–3.22) | 2.53 (2.27–2.82) |
|
| |||
| Cardiovascular disease | |||
| No diabetes | 2550/10 466 | 1.00 (reference) | 1.00 (reference) |
|
| |||
| Unconfirmed undiagnosed diabetes | 180/515 | 1.52 (1.31–1.77)§ | 1.20 (1.03–1.40)§ |
|
| |||
| Confirmed undiagnosed diabetes | 146/347 | 1.99 (1.68–2.36)§ | 1.52 (1.28–1.81)§ |
|
| |||
| Diagnosed diabetes | 429/839 | 2.75 (2.48–3.06) | 2.17 (1.95–2.43) |
|
| |||
| Peripheral artery disease | |||
| No diabetes | 308/10 819 | 1.00 (reference) | 1.00 (reference) |
|
| |||
| Unconfirmed undiagnosed diabetes | 20/570 | 1.24 (0.79–1.95)§ | 0.93 (0.59–1.48)§ |
|
| |||
| Confirmed undiagnosed diabetes | 34/368 | 3.50 (2.44–5.01)§ | 2.47 (1.70–3.57)§ |
|
| |||
| Diagnosed diabetes | 130/996 | 5.60 (4.53–6.92) | 4.03 (3.19–5.09) |
|
| |||
| All-cause mortality | |||
| No diabetes | 4110/11 290 | 1.00 (reference) | 1.00 (reference) |
|
| |||
| Unconfirmed undiagnosed diabetes | 304/595 | 1.45 (1.29–1.63) | 1.29 (1.15–1.45) |
|
| |||
| Confirmed undiagnosed diabetes | 216/383 | 1.67 (1.45–1.91) | 1.48 (1.29–1.71) |
|
| |||
| Diagnosed diabetes | 743/1078 | 2.31 (2.13–2.50) | 1.98 (1.82–2.16) |
ARIC = Atherosclerosis Risk in Communities; HbA1c = hemoglobin A1c.
No diabetes was defined as HbA1c level <6.5% and fasting glucose level <126 mg/dL among persons without diagnosed diabetes. Unconfirmed undiagnosed diabetes was defined as HbA1c level ≥6.5% or fasting glucose level ≥126 mg/dL but not elevated levels of both HbA1c and fasting glucose among persons without diagnosed diabetes. Confirmed undiagnosed diabetes was defined as HbA1c level ≥6.5% and fasting glucose level ≥126 mg/dL among persons without diagnosed diabetes. Diagnosed diabetes was defined as self-reported physician diagnosis of diabetes or current use of glucose-lowering medication. After exclusions for prevalent disease, the sample sizes for the analyses were 12 199 for incident diagnosed diabetes, 13 080 for chronic kidney disease, 12 167 for cardiovascular disease, 12 753 for peripheral artery disease, and 13 346 for mortality (Appendix Figure 1).
Included age, sex, and race–center.
Included age, sex, race–center, body mass index, education, drinking and smoking status, total and high-density lipoprotein cholesterol levels, triglyceride levels, systolic and diastolic blood pressure, blood pressure–lowering medication use, family history of diabetes, and estimated glomerular filtration rate.
P < 0.05 for confirmed vs. unconfirmed groups.