THE INCIDENCE OF DIABETES-MELLITUS IN AN ENGLISH COMMUNITY - A 20-YEAR FOLLOW-UP OF THE WHICKHAM SURVEY

The original Whickham Survey documented the prevalence of diabetes and lipid disorders in a sample of 2779 adults aged 18 years and over, wh ich matched the British population structure. The aim of the 20-year f ollow-up study was to determine the incidence and natural history of d iabetes. Outcomes in terms of morbidity and mortality at follow-up wer e determined in over 97 % of the original population. Ninety-four subj ects had been identified and treated for diabetes since the first surv ey, including 17 subjects identified as having a fasting plasma glucos e greater than or equal to 7.8 mmol I-1 at follow-up. The incidence of diabetes for the total population was 2.2 1000(-1) year(-1) (95 % con fidence interval 1.8, 2.6). The risk factors identified at first surve y were corrected for age, cut-off at the 95 centile and entered into a log linear model. Those which strongly predicted development of diabe tes in the total population were fasting blood glucose (odds ratio (OR ) (with 95 % confidence intervals) = 2.3 (1.5, 3.5)) and body mass ind ex (OR = 2.2 (1.5, 3.3)) in men, and fasting blood glucose (OR 2.6 (1. 7, 4.1)) and fasting serum triglyceride (OR = 2.8 (1.8, 4.4)) in women . A legit model has enabled the calculation of the probability of deve loping diabetes 20 years later. It was the characteristics of becoming older such as obesity, hypertriglyceridaemia, and raised fasting bloo d glucose, rather than age itself, which were associated with the deve lopment of diabetes.