Model of complications of NIDDM. I. Model construction and assumptions
Model of complications of NIDDM. I. Model construction and assumptions. R C Eastman , J C Javitt , W H Herman , E J Dasbach , A S Zbrozek , F Dong , D Manninen , S A Garfield , C Copley-Merriman , W Maier , J F Eastman , J Kotsanos , C C Cowie and M Harris Division of Diabetes, Endocrinology, and Me...
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Published in | Diabetes care Vol. 20; no. 5; pp. 725 - 734 |
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Main Authors | , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Alexandria, VA
American Diabetes Association
01.05.1997
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Subjects | |
Online Access | Get full text |
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Summary: | Model of complications of NIDDM. I. Model construction and assumptions.
R C Eastman ,
J C Javitt ,
W H Herman ,
E J Dasbach ,
A S Zbrozek ,
F Dong ,
D Manninen ,
S A Garfield ,
C Copley-Merriman ,
W Maier ,
J F Eastman ,
J Kotsanos ,
C C Cowie and
M Harris
Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases,
Bethesda, Maryland 20892-2560, USA.
Abstract
OBJECTIVE: To develop a model of NIDDM for analyzing prevention strategies for NIDDM. RESEARCH DESIGN AND METHODS: A Markov
type model with Monte Carlo techniques was used. Age, sex, and ethnicity of cohort was based on U.S. data. Incidence rates
of complications were also based on community and population studies. RESULTS: Nonproliferative retinopathy, proliferative
retinopathy, and macular edema are predicted in 79, 19, and 52%, respectively, of people with NIDDM; 19% are predicted to
develop legal blindness. Microalbuminuria, gross proteinuria, and end-stage renal disease related to diabetes are predicted
in 53, 40, and 17%, respectively. Symptomatic sensorimotor neuropathy and lower-extremity amputation are predicted in 31 and
17%, respectively. Cardiovascular disease is predicted in 39%. Higher rates of complications (1.1-3.0x) are predicted in minority
populations. Predicted average life expectancy is 17 years after diagnosis. CONCLUSIONS: A probabilistic model of NIDDM predicts
the vascular complications of NIDDM in a cohort representative of the incident cases of diabetes in the U.S. before age 75
years. Predictions of complications and mortality are consistent with the known epidemiology of NIDDM. The model is suitable
for evaluating the effect of preventive interventions on the natural history of NIDDM. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0149-5992 1935-5548 |
DOI: | 10.2337/diacare.20.5.725 |