Discussion Of Biochemical Indicators In Diagnosis And Cancer Risk Analysis Of Diabetes

Diabetes has become a public health problem that poses a serious threat to global human health.Its related Real-World Studies can provide Real-World Evidence,and help early detection,diagnosis and treatment of diabetes.Therefore,based on the Shanghai Shenkang Hospital Link database,we studied the correlation between HbA1 c,FPG and 2h PG in a diabetic population,and explored the real application effects of these three biochemical indicators in diabetes diagnosis.The generalized additive models showed that there were significant nonlinear positive correlations among HbA1 c,FPG and 2h PG.Compared with FPG(84.03%)and 2h PG(85.81%),HbA1 c had the highest sensitivity in the diagnosis of diabetes(90.14%),and the combined sensitivity of HbA1 c and blood glucose testing was higher.Given that HbA1 c showed good diagnostic effect for diabetes in the above study,in order to determine whether the age-related effect need to be considered when applying HbA1 c,we further investigated the correlation between age and HbA1 c,and whether it was affected by gender and BMI.The results showed that the HbA1 c levels gradually increased along with age,and there is a positive association between BMI and the HbA1 c,both in female and male.Futhermore,in all the BMI subgroups aged 20-39,the 97.5th percentiles of HbA1 c levels were lower than 6.5%,suggesting that the current HbA1 c cutoff value may be higher for the young population.Therefore,we recommend that the effects of age should be taken into consideration when using HbA1 c for the diagnosis and management of diabetes,especially in the young population.The relationship between diabetes and cancer was also a research hotspot in recent years.The previously reported findings of the association between type 2 diabetes and cancer risk have not all been consistent,and only a few studies were conducted in mainland China.Therefore,based on the Shanghai Shenkang Hospital Link database,we investigated the risk of 23 common cancer sites among patients with type 2 diabetes.We finally identified 410,191 patients with type 2 diabetes(aged 20-99 years)from July 2013 to December 2016,and followed up for cancer incidence until December 2017.A total of 8,485 cases(4,312 males and 4,173 females)of newly diagnosed cancer were identified.For all cancer sites combined,the risks of males and females with type 2 diabetes increased by 34% and 62%,and the cancer risk varied by specific site,with 11 and 13 cancer sites increasing risk,respectively.Therefore,we suggested that establishing strategies of cancer-specific regular screening and prevention care among patients with type 2 diabetes is necessary.