ArticleThe journal of spinal cord medicine2025
Spinal cord injury-specific prognostic risk assessment tool for development of type 2 diabetes.
Article in The journal of spinal cord medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
contextAvailable diabetes risk calculators were developed for able-bodied individuals, but their metabolic profile is different from individuals with spinal cord injury.
objectivesWe aimed to develop a diabetes risk assessment tool specific to individuals with spinal cord injury.
methodsWe used national Veterans Affairs data to identify patients with at least a 2-year history of spinal cord injury and no prior history of diabetes with a Veterans Heath Affairs visit from 2005-2007, and followed the 11,054 individuals that met inclusion criteria for up to 17 years to assess diabetes development. We used least absolute shrinkage and selection operator (LASSO) Cox regression to develop prognostic diabetes prediction models and evaluated these models on discrimination and calibration.
results2937 subjects developed diabetes during follow-up; median follow-up time was 8.7 years (IQR 3.3, 15.4). The first model selected 17 predictors and demonstrated median discrimination of 0.70 (IQR 0.69, 0.72) at 15 years. The second, more parsimonious model with 4 selected predictors demonstrated median discrimination of 0.69 (IQR 0.68, 0.71) at 15 years. Both models demonstrated good calibration across predicted risk, with better calibration in the 17-predictor model.
conclusionThese spinal cord injury-specific risk calculators can be used by both patients and providers in assessing risk of diabetes development, and in shared decision making regarding surveillance and prevention.
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