Incidence of diabetes mellitus and associated risk factors in the adult population of the Basque country, Spain
Inés Urrutia, Alicia Martín-Nieto, Rosa Martı́nez, Josep‐Oriol Casanovas‐Marsal, Aníbal Aguayo, Juan del Olmo, Eunate Arana‐Arri, Elsa Fernández-Rubio, Luís Castaño, Sonia Gaztambide, The Diabetes Epidemiology Group, Alejandro García‐Castaño, Sara Gómez‐Conde, Sara Larrauri, Idoia Martinez de la Piscina, Laura Saso, Olaia Velasco
Abstract
The aim of this study was to estimate the incidence of diabetes mellitus in the Basque Country and the risk factors involved in the disease by reassessing an adult population after 7 years of follow-up. In the previous prevalence study, 847 people older than 18 years were randomly selected from all over the Basque Country and were invited to answer a medical questionnaire, followed by a physical examination and an oral glucose tolerance test. In the reassessment, the same variables were collected and the resulting cohort comprised 517 individuals of whom 43 had diabetes at baseline. The cumulative incidence of diabetes was 4.64% in 7 years and the raw incidence rate was 6.56 cases/1000 person-years (95%CI: 4.11-9.93). Among the incident cases, 59% were undiagnosed. The most strongly associated markers by univariate analyses were age > 60 years, dyslipidaemia, prediabetes and insulin resistance. We also found association with hypertension, obesity, family history of diabetes and low education level. Multivariate analysis adjusted for age and sex showed that a set of risk factors assessed together (dyslipidaemia, waist-to-hip-ratio and family history of diabetes) had great predictive value (AUC-ROC = 0.899, 95%CI: 0.846-0.953, p = 0.942), which suggests the need for early intervention before the onset of prediabetes.