Trial reportDiabetologia2011
HbA1c and cardiovascular risk score identify people who may benefit from preventive interventions: a 7 year follow-up of a high-risk screening programme for diabetes in primary care (ADDITION), Denmark.
Trial report in Diabetologia, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Screening for type 2 diabetes mellitus.The Cochrane database of systematic reviews · 2020Pooled it
- A plasma circulating miRNAs profile predicts type 2 diabetes mellitus and prediabetes: from the CORDIOPREV study.Experimental & molecular medicine · 2018Trial
- Stratified patient-centered care in type 2 diabetes: a cluster-randomized, controlled clinical trial of effectiveness and cost-effectiveness.Diabetes care · 2013Trial
- Protocol for ADDITION-PRO: a longitudinal cohort study of the cardiovascular experience of individuals at high risk for diabetes recruited from Danish primary care.BMC public health · 2012Trial
- Changes in type 2 diabetes incidence and mortality associated with introduction of HbA1c as diagnostic option: A Danish 24-year population-based study.The Lancet regional health. Europe · 2022Article
- Care Team Integration in Primary Care Improves One-Year Clinical and Financial Outcomes in Diabetes: A Case for Value-Based Care.Population health management · 2020Article
- Making Inroads in Addressing Population Health in Underserved Communities With Type 2 Diabetes.Diabetes spectrum : a publication of the American Diabetes Association · 2019Article
- Risk of dementia and cognitive dysfunction in individuals with diabetes or elevated blood glucose.Epidemiology and psychiatric sciences · 2019Article
- HbA1c for diagnosis of type 2 diabetes. Is there an optimal cut point to assess high risk of diabetes complications, and how well does the 6.5% cutoff perform?Diabetes, metabolic syndrome and obesity : targets and therapy · 2013Review
- HbA₁c versus oral glucose tolerance test as a method to diagnose diabetes mellitus in vascular surgery patients.Cardiovascular diabetology · 2013Article
- Fasting plasma glucose and HbA1c in cardiovascular risk prediction: a sex-specific comparison in individuals without diabetes mellitus.Diabetologia · 2013Article
- The worldwide epidemiology of type 2 diabetes mellitus--present and future perspectives.Nature reviews. Endocrinology · 2011Review
- Prognostic value of haemoglobin A1c and fasting plasma glucose for incident diabetes and implications for screening.European journal of epidemiology · 2011Article
- Management of periodontal disease in patients with diabetes- good clinical practice guidelines: A joint statement by Indian Society of Periodontology and Research Society for the Study of Diabetes in India.Journal of Indian Society of PeriodontologyArticle
- RSSDI-ESI Clinical Practice Recommendations for the Management of Type 2 Diabetes Mellitus 2020.Indian journal of endocrinology and metabolismArticle
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aims/hypothesisThe measurement of HbA(1c) is suggested as a diagnostic test for diabetes. Screening for diabetes also identifies individuals with elevated cardiovascular risk but who are free of diabetes. This study aims to assess whether screening by HbA(1c) or glucose measures alone, or in combination with a cardiovascular risk assessment, identifies people who may benefit from preventive interventions, i.e. people with screen detected diabetes and people belonging to groups with excess mortality, during a median follow-up of 7 years.
methodsA population-based, stepwise high-risk screening programme was performed in 193 family practices from 2001 to 2006. Individuals aged between 40 and 69 years (N = 163,185) were sent a diabetes risk questionnaire. Of these, 20,916 people at risk of diabetes were stratified by glucose measures (normal glucose tolerance [NGT], impaired fasting glucose [IFG], impaired glucose tolerance [IGT] and diabetes), HbA(1c) (<6%; 6.0-6.4%; or ≥ 6.5%) and cardiovascular risk (heart SCORE <5 or ≥ 5). People were followed for a median of 7 years or until death. Excess mortality was calculated using the Cox hazard ratio (HR).
resultsSCORE ≥ 5 identified 91.7% (95% CI 91.1-92.3%) of those who might benefit from preventive interventions. SCORE ≥ 5 in combination with HbA(1c) ≥ 6.0% identified 96.7% (95% CI 96.3-97.0%), compared with 97.6% (95%CI 97.2-97.9%) in combination with glucose measures. Glucose measures or HbA(1c) alone identified 26.1% (95% CI 25.2-27.0%) and 19.8% (95% CI 19.0-20.6%), respectively. CONCLUSION/
interpretationIn a population-based high risk screening programme in primary care, HbA(1c) ≥ 6.0% combined with an elevated cardiovascular risk assessment (SCORE ≥ 5) can feasibly be used to identify those who may benefit from preventive lifestyle intervention and/or polypharmacy.
trial registrationClinicalTrials.gov NCT 00237549.
fundingThe study received unrestricted grants from Novo Nordisk, Novo Nordisk Scandinavia, Astra Denmark, Pfizer Denmark, GlaxoSmithKline Pharma Denmark, Servier Denmark and HemoCue Denmark.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.