Diabetics do you want to know your complication risk?

Researchers in the United Kingdom have developed a validated risk assessment equation to show the 10-year risk of blindness and lower limb amputation in diabetes patients. Such tools have already been developed for the general population to assess heart attack, stroke and diabetes risk, and now the QDiabetes tool is the first tool for diabetics that gives an accurate assessment of their risk of these most feared complications.

Data has been collected from English General Practitioners since 1998 from over 400,000 patients. The algorithms are based on variables that patients are likely to know or that can be found from asking your GP. Knowing your risk could be worthwhile so you would know to intensify your control and monitor your condition more stringently.

For clinicians, complication risk could enable screening programs to be tailored to an individual’s need for support and the more rational use of scarce resources. Retinopathy could be done more frequently than once a year for those who need it and less frequently than once a year for those who do not. Those at higher risk of amputation might benefit from a proactive targeted program to prevent lower extremity amputation (including more frequent checks, tailored patient education, specially designed protective footwear, and early reporting of foot injuries), as this has been shown to substantially reduce the risk of emergency admissions, use of antibiotics, foot operations, and lower limb amputation compared with usual practice.



I found this diabetes complication calculator at the excellent site co run by Dr. Katharine Morrison which can be found at link below. How accurate this tool is, is open to debate, but if it is a good indicator for future complications, as a type two diabetic I would be happy with the results it gave me. Let's face it, all diabetics have a higher risk of complactions, but we can drastically improve our chances of not succumbing to serious complications by holding excellent blood glucose numbers.

One problem with the calculator is the fact the minimum HbA1c you can enter is 40, mine is lower than that, as is many other diabetics I know. As you would expect, all of these people are low carbers. Perhaps the people that designed this tool thought no diabetics ever hold numbers better than 40. Maybe by inserting my lower than 40 HbA1c my results would have been better, who knows.

The future risk of complications calculator can be found here

http://qdiabetes.org/amputation-blindness/

Dr. Katharine Morrison's site which can be found here

http://diabetesdietblog.com/

Did anyone else try this tool out? If so what were your results.

Eddie wrote:Did anyone else try this tool out? If so what were your results.

Well mines slightly higher than yours probably down to my age   

Looks like a case of "Could do better" methinks!

Paul1976 wrote:

Looks like a case of "Could do better" methinks!

Don't put yourself down mate. With what you have had to contend with over the last few years you are doing great. Very few type ones hold your numbers. A tweak here and a tweak there and you will get a better result. My results may have been lower, but I have more than a slim chance of croaking over the next ten years. Bring on the Jim Beam's

I always find it interesting playing with these risk calculators.  Set all but one of the variables and then see what happens when you alter the remaining one.  

Firstly, I was interested in the HbA1c, partly to try and get an idea of what a lower than 40 HbA1c would produce by extending the line on a graph back to lower levels.  I was surprised to find how shallow the line actually was.  My fixed numbers were white, male, non-smoker, 65 with a systolic bp of 130.  An HbA1c of 40 gave a blindness risk of 2%, going up to HbA1c of 90, which gave 3.2%.  Working back this would mean an HbA1c of 20 (!) would have a risk of 1.6%.  This is beginning to look like nonsense, or is it just me?

Then I made systolic blood pressure my variable.  Surprisingly, lower (below 120mmHg) wasn't better.  130 was the best place to be with my fixed figures, but things only took a turn for the worse at over 170!  No need to drug yourself into the lowest possible numbers then.

Finally I played with "age".  As is often the case, this has the most effect.  it would seem that being diabetic for 5 years at age 80 puts you in a riskier place than being diabetic for five years age 60, even though you've got longer to go.

Fun to play with, but no need to get too worried about it all.  Just another reason for your GP to look at her/his computer, instead of you.  Medicine by numbers.

Sally

Sally wrote:I always find it interesting playing with these risk calculators.  Set all but one of the variables and then see what happens when you alter the remaining one.  

Firstly, I was interested in the HbA1c, partly to try and get an idea of what a lower than 40 HbA1c would produce by extending the line on a graph back to lower levels.  I was surprised to find how shallow the line actually was.  My fixed numbers were white, male, non-smoker, 65 with a systolic bp of 130.  An HbA1c of 40 gave a blindness risk of 2%, going up to HbA1c of 90, which gave 3.2%.  Working back this would mean an HbA1c of 20 (!) would have a risk of 1.6%.  This is beginning to look like nonsense, or is it just me?

Then I made systolic blood pressure my variable.  Surprisingly, lower (below 120mmHg) wasn't better.  130 was the best place to be with my fixed figures, but things only took a turn for the worse at over 170!  No need to drug yourself into the lowest possible numbers then.

Finally I played with "age".  As is often the case, this has the most effect.  it would seem that being diabetic for 5 years at age 80 puts you in a riskier place than being diabetic for five years age 60, even though you've got longer to go.

Fun to play with, but no need to get too worried about it all.  Just another reason for your GP to look at her/his computer, instead of you.  Medicine by numbers.

Sally

A great post Sally, I agree with you. I think we should look at this tool as a rough guide. As we all know there are a 1001 variables with diabetes as with many other health conditions. A diabetic could look to have a good chance of avoiding the two complications mentioned, but go down with a different complication such as CVD.

Maybe in time as more data is added and the algorithm becomes more refined the tool will become more accurate. The bottom line, it may help to encourage some to better control of their diabetes.