Colorectal adenomas and diabetes: implications for disease prevention

TY - JOUR

T1 - Colorectal adenomas and diabetes

T2 - implications for disease prevention

AU - Steele, R. J. C.

AU - Anderson, A. S.

AU - Macleod, M.

AU - Craigie, A. M.

AU - Caswell, S.

AU - Belch, J.

AU - Treweek, S.

AU - on behalf of the BeWEL team

N1 - This article is protected by copyright. All rights reserved.

PY - 2015/7

Y1 - 2015/7

N2 - AIM: The study assessed the baseline type II diabetes mellitus (T2DM) risk status among overweight patients with screen-detected colorectal adenomas and explored the implications of the findings for preventative practice.METHOD: Participants, aged 50-74 years (73% male) recruited from four Scottish health boards were assessed for diabetes risk. Participants were categorised as at 'high' diabetes risk if HbA1c ranged between 6.0 to 6.4% or fasting plasma glucose (FPG) ranged from 5.5 to 6.9mmol/l and as potentially undiagnosed T2DM when HbA1c ≥6.5% or FPG ≥7mmol/l. Secondary outcome measures included anthropometric measurements, blood pressure and plasma lipid profile. The tests were repeated at 12 months and diabetes risk categories were re-assessed following intervention procedures.RESULTS: Of the 329 participants, a pre-existing diagnosis of T2DM had been made in 47(14.3%). Of the remainder with complete biochemistry results (n=250), 19 (7.6%) were classified as having potentially undiagnosed T2DM and 125 (50.0%) as being at high risk of developing diabetes. More than a quarter of participants in all categories had raised waist circumference, hypertension and plasma lipids indicative of raised cardiovascular risk. At 12 months follow up, diabetes risk category diminished in 20% of the intervention group versus 11% in control [OR 2.26 (95%CI 1.03 - 4.96)].CONCLUSION: Results suggest that an diagnosis of adenoma in overweight patients provides a health service opportunity for diabetes assessment, prevention and management in a high risk population at a potentially teachable moment. This article is protected by copyright. All rights reserved.

AB - AIM: The study assessed the baseline type II diabetes mellitus (T2DM) risk status among overweight patients with screen-detected colorectal adenomas and explored the implications of the findings for preventative practice.METHOD: Participants, aged 50-74 years (73% male) recruited from four Scottish health boards were assessed for diabetes risk. Participants were categorised as at 'high' diabetes risk if HbA1c ranged between 6.0 to 6.4% or fasting plasma glucose (FPG) ranged from 5.5 to 6.9mmol/l and as potentially undiagnosed T2DM when HbA1c ≥6.5% or FPG ≥7mmol/l. Secondary outcome measures included anthropometric measurements, blood pressure and plasma lipid profile. The tests were repeated at 12 months and diabetes risk categories were re-assessed following intervention procedures.RESULTS: Of the 329 participants, a pre-existing diagnosis of T2DM had been made in 47(14.3%). Of the remainder with complete biochemistry results (n=250), 19 (7.6%) were classified as having potentially undiagnosed T2DM and 125 (50.0%) as being at high risk of developing diabetes. More than a quarter of participants in all categories had raised waist circumference, hypertension and plasma lipids indicative of raised cardiovascular risk. At 12 months follow up, diabetes risk category diminished in 20% of the intervention group versus 11% in control [OR 2.26 (95%CI 1.03 - 4.96)].CONCLUSION: Results suggest that an diagnosis of adenoma in overweight patients provides a health service opportunity for diabetes assessment, prevention and management in a high risk population at a potentially teachable moment. This article is protected by copyright. All rights reserved.

U2 - 10.1111/codi.12895

DO - 10.1111/codi.12895

M3 - Article

C2 - 25581207

SN - 1462-8910

VL - 17

SP - 589

EP - 594

JO - Colorectal Disease

JF - Colorectal Disease

IS - 7

ER -