Affiliation:
1. 1University of Western Australia Medical School, Fremantle Hospital, Fremantle, Western Australia, Australia
2. 2Department of Endocrinology and Diabetes, Fiona Stanley and Fremantle Hospitals Group, Murdoch, Western Australia, Australia
3. 3Lions Outback Vision, Lions Eye Institute, Nedlands, Australia
Abstract
OBJECTIVE
To assess whether there are clusters of people with type 2 diabetes with distinct temporal profiles of lung function changes and characteristics.
RESEARCH DESIGN AND METHODS
Group-based trajectory modeling (GBTM) identified groups of participants with type 2 diabetes from the community-based observational Fremantle Diabetes Study Phase II (FDS2) who had at least two biennial measurements of forced expiratory volume in 1 s as a percentage of predicted (FEV1%pred) over 6 years. Independent associates of group membership were assessed using multinomial regression.
RESULTS
Of 1,482 potential FDS2 participants, 1,074 (72.5%; mean age, 65.2 years; 45.5% female; median diabetes duration, 8.0 years) were included in the modeling. The best fitting GBTM model identified four groups categorized by FEV1%pred trajectory: high (19.5%; baseline FEV1%pred, 106.5 ± 9.5%; slope 0%/year), medium (47.7%; FEV1%pred, 87.3 ± 8.7%; slope, −0.32%/year), low (25.0%; baseline FEV1%pred, 68.9 ± 9.8%; slope, −0.72%/year), and very low (7.9%; baseline FEV1%pred, 48.8 ± 9.6%; slope, −0.68%/year). Compared with the high group, the other groups were characterized by nonmodifiable and modifiable risk factors associated with lung function decline in the general population (including ethnicity, marital status, smoking, obesity, coronary heart disease, and chronic respiratory disease). The main, diabetes-specific, significant predictor of group membership was a higher HbA1c in the very low group. There was a graded increase in mortality from 6.7% in the high group to 22.4% in the very low group.
CONCLUSIONS
Measurement of lung function in type 2 diabetes could help optimize clinical management and improve prognosis, including addressing glycemic control in those with a very low FEV1%pred.
Funder
Medical Research Future Fund Practitioner Fellowship
National Health and Medical Research Council of Australia
Publisher
American Diabetes Association
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献