Background Diabetic retinopathy and proteinuria, manifestations of microvascular abnormalities, occur early in the course of diabetes mellitus; in contrast, macrovascular cardiovascular complications usually occur later. We aimed to identify (a) the number and characteristics of patients, 18-65 years, newly diagnosed with diabetes, who needed psychosocial interventions and (b) the type of psychosocial problems they had. Compared to non-diabetic patients, patients with diabetes were older and showed more comorbidity [myocardial infarction (32% vs. Relative access to health-harming food outlets was associated with greater likelihood of both prevalent and incident T2D in a curvilinear manner, with the highest risk being observed for environments in which one-third of outlets were health-harming. The diabetes patients in poor metabolic control reported more retinopathy, vascular complications and nervous problems than did the patients in acceptable metabolic control. 58% of our patients were obese or overweight (BMI≥25kg/m2), hypertension was present in 22%, hypertriglyceridemia in 27% and high LDL cholesterol in 27%. Additionally, cooperation with a diabetes nurse was associated with a lower yield.
This thesis seeks to address key questions on identification of IGR, determine factors predicting progression to T2DM and thus propose prevention strategies in a mixed ethnic population in the UK using data from the ADDITION Leicester and ADDITION PLUS studies.