Prevalence of diabetic eye disease in Tayside, Scotland (P-DETS) study: methodology.

AIMS: To describe the use of a validated diabetes register for sampling frame generation and assessment of the representative nature of participants in a fieldwork study of diabetic eye disease. METHODS: We performed an observational, cross-sectional fieldwork study of diabetic retinal disease using reference standard eye examination. We sampled the entire diabetic population using the Diabetes Audit and Research in Tayside Study (DARTS) diabetes register. RESULTS: The study population comprised 4825 diabetic patients aged over 16 years registered with one of 166 general practitioners (GPs) in 41 practices in Tayside in October 1999. This represented 61.1% of the Tayside diabetic population (7903). A total of 586 (66%; 95% confidence interval 63, 70) patients were examined from a sampling frame of 882 living patients registered with a Tayside GP. Demographic and disease parameters recorded on the DARTS patient register allowed comparison between participants and non-participants. CONCLUSIONS: This study shows the clear benefit of using a complete diabetic population as a sampling frame. This allows potential selection bias and external validity to be evaluated using routine data sources. Studies performed and reported in this way will aid the critical appraisal process.     

High prevalence of ischaemia, infection and serious comorbidity in patients with diabetic foot disease in Europe. Baseline results from the Eurodiale study

Aims/hypothesis Large clinical studies describing the typical clinical presentation of diabetic foot ulcers are limited and most studies were performed in single centres with the possibility of selection of specific subgroups. The aim of this study was to investigate the characteristics of diabetic patients with a foot ulcer in 14 European hospitals in ten countries. Methods The study population included 1,229 consecutive patients presenting with a new foot ulcer between 1 September 2003 and 1 October 2004. Standardised data on patient characteristics, as well as foot and ulcer characteristics, were obtained. Foot disease was categorised into four stages according to the presence or absence of peripheral arterial disease (PAD) and infection: A: PAD −, infection −; B: PAD −, infection +; C: PAD +, infection −; D: PAD +, infection +. Results PAD was diagnosed in 49% of the subjects, infection in 58%. The majority of ulcers (52%) were located on the non-plantar surface of the foot. With regard to severity, 24% had stage A, 27% had stage B, 18% had stage C and 31% had stage D foot disease. Patients in the latter group had a distinct profile: they were older, had more non-plantar ulcers, greater tissue loss and more serious comorbidity. Conclusions/interpretation According to our results in this European cohort, the severity of diabetic foot ulcers at presentation is greater than previously reported, as one-third had both PAD and infection. Non-plantar foot ulcers were more common than plantar ulcers, especially in patients with severe disease, and serious comorbidity increased significantly with increasing severity of foot disease. Further research is needed to obtain insight into the clinical outcome of these patients.     

Bone loss in diabetic patients with chronic kidney disease.

OBJECTIVE: We investigated whether loss of bone is detectable during follow-up of diabetic patients with chronic kidney disease (CKD). RESEARCH DESIGN AND METHODS: In 40 initially non-dialysed diabetic patients with CKD (isotopic glomerular filtration rate < 60 ml/min/1.73 m(2) or albumin excretion rate > 30 mg/24 h), body composition (DEXA scan) and glomerular filtration rate (GFR determined from (51)Cr-EDTA clearance) were measured at a 2-year interval, and compared by paired t-tests. RESULTS: The 40 patients, mainly with Type 2 diabetes (n = 28), were men (n = 28), aged 65 +/- 11 years, with diabetes duration 18 +/- 11 years. GFR was initially 38.0 (range 8-89) ml/min/1.73 m(2). CKD progressed during follow-up: eight started haemodialysis and GFR declined in the 32 others (P < 0.05 vs. initial). T-scores for total body (initial -0.61 +/- 1.11, final -1.11 +/- 1.40; P < 0.001) and femoral neck (initial -1.88 +/- 0.15, final -2.07 +/- 0.15; P < 0.05) declined. Ten patients were osteopaenic at baseline (no osteoporosis), whereas most were osteopaenic (n = 21, P < 0.05) and five were osteoporotic at final assessment. The 16 patients who became osteopaenic or osteoporotic during follow-up did not differ from the others for the type of diabetes, age, GFR, albumin excretion rate, HbA(1c), GFR reduction and the requirement for dialysis during follow-up. They were all men (P < 0.01 by chi-squared test), with reduced initial total body T-score (-1.20 +/- 0.82, others -0.32 +/- 1.13; P < 0.05) and a lower body mass index (24.6 +/- 4.3; others 27.7 +/- 4.3; P < 0.05). CONCLUSION: Bone loss, especially in the femoral neck, is progressive in diabetic patients with CKD.     

Increasing prevalence and incidence of thyroid disease in Tayside, Scotland: the Thyroid Epidemiology Audit and Research Study (TEARS)

Objective We aimed to describe the changing incidence of thyroid disease in a population‐based study in Tayside, Scotland (population 390 000) between 1994 and 2001. Design A retrospective, data‐linkage, population‐based study measuring the incidence and prevalence of thyroid disease. Patients All patients with newly diagnosed, treated and stable thyroid disease in Tayside were identified by electronic linkage of six datasets, including all regional biochemistry data, hospital admissions, deaths and a thyroid follow‐up register. Results The overall prevalence of thyroid dysfunction has increased from 2·3% to 3·8% (1994–2001). The prevalence of ever having had hyperthyroidism increased from 0·86% to 1·26% in females and 0·17% to 0·24% in males (P < 0·0001 for both). The standardized incidence of hyperthyroidism increased from 0·68 to 0·87 per 1000 females/year, representing a 6·3% annual increase (P < 0·0001). The prevalence of primary hypothyroidism increased from 3·12% to 5·14% in females and 0·51% to 0·88% in males (P < 0·0001 for both). The standardized incidence of primary hypothyroidism did not change and varied between 3·90 and 4·89 per 1000 females/year over the 8 years. Incidence of hypothyroidism in males increased from 0·65 to 1·01 per 1000 males/year (P = 0·0017). Mean age at diagnosis of primary hypothyroidism declined in females from 1994 to 2001. Conclusions The prevalence of primary hypothyroidism and previous hyperthyroidism has increased in Tayside, Scotland. This is partly due to an increasing incidence of disease, increased ascertainment and earlier diagnosis of disease. This will result in an increased workload for endocrinologists and general practitioners.     

Revision of the ADA-classification of diabetes mellitus type 2 (DMT2): The importance of maturity onset diabetes (MOD), and senile diabetes (DS)

The changing social and economic conditions and the increase of the life span induced a progressive increase of the general prevalence of DMT2, particularly in the elderly population of the highly evoluted countries. Up to now 18 genetic loci have been identified, each of them consisting of several single nucleotide polymorphisms (SNPs). The evidence that the DMT2 is regulated by a high number of genes, demonstrate the pathogenetic complexity of this disease. The onset of diabetes mellitus (DM) in medium age is a consequence of the breakdown of the glycemic homeostasis in correlation with the genetic factors, such as the variants of the TCF7L2, obesity, etc., and the environmental factors, such as the life-style, the evolution of chronic-degenerative diseases, etc. In case of DM that onsets in old age we have to add the deterioration of the anti-aging defense mechanisms, characterized by the antagonistic action of the genes of longevity and aging. One can observe several clinical and therapeutic differences; therefore, the authors of this review propose the reinsertion of three forms into the DMT2 correlated with the age of onset and with the actual age of the subjects: the maturity onset diabetes (MOD), the maturity onset diabetes in elderly (MODE), and the senile diabetes (DS).     

Use of the accident and emergency department by patients with diabetes.

As part of a District-based audit of diabetes care all attendances (of diabetic and non-diabetic patients) at a local Accident and Emergency department were monitored over a 3-month period. A total of 9505 attendances took place of which 62 (0.7%) were by people with diabetes. This was no different from the expected number of attendances (61.5) based on the rates seen in non-diabetic individuals. Of these 62 attendances, 20 (by 15 individuals) were directly related to diabetes (hypoglycaemia 17, hyperglycaemia 1, for supplies of insulin or equipment 2). When these diabetes-specific attendances were removed from the total, the number of attendances (42) was significantly (p = 0.004) less than that expected. Diabetic males aged 0-19 years attended significantly more often than non-diabetic individuals of the same age but this excess was solely attributable to diabetes.     

Epidemiology of type 1 (insulin-dependent) diabetes in Scotland 1968–1976: Evidence of an increasing incidence

Summary A computer file of all Scottish hospital admissions in the period 1968–1976 was searched to identify the 2,505 children (aged < 19 years) with a diagnosis of diabetes. The average annual incidence of the disease (based on first hospital admission) was estimated to be 13.8 per 100,000 children aged < 19 years (boys 14.4 per 100,000; girls 13.2 per 100,000). The highest incidence, 20.0 per 100,000 was in the age group 10–14 years and the lowest 7.1 per 100,000 in those aged < 5 years. It is estimated that during the study period there was an 80% increase in the annual incidence of juvenile diabetes, from about 10 per 100,000 in 1968 to about 18 per 100,000 in 1976. First admission rates showed seasonal variations for those aged 5 years or more, with peaks in October/November and January/February. Marked variation was found in the incidence rates in the different counties of Scotland. The central lowlands which includes the cities of Edinburgh and Glasgow was an area of low incidence. There appeared to be an inverse correlation between the incidence rate in each county and population density. In Glasgow, there was an inverse association between the incidence rate in each city ward and the average number of persons per room. There was no evidence of space-clustering of the disease in different years within the parishes (rural districts) of each county and there was no convincing evidence that the variation in the incidence of diabetes between parishes in the same county was more than might have been expected to arise by chance. The observations are compatible with the disease having a viral aetiology but it is difficult to explain the striking rise in incidence over the study period on this basis.     

Subclinical diabetic neuropathy: similarities between electrophysiological results of patients with Type 1 (insulin-dependent) and Type 2 (non-insulin-dependent) diabetes mellitus

Summary Type 1 (insulin-dependent) and Type 2 (non-insulin-dependent) diabetic patients share many clinical and biochemical characteristics. However, sural nerve biopsies from patients with advanced and chronic neuropathy show ultrastructural differences between these two groups. We investigated whether at a subclinical stage of the illness, when Type 1 and Type 2 diabetic patients are clinically uniform and the histopathological nerve alterations are not advanced, comparison between the two diabetes groups might show differences in nerve fibre involvement related to the different pathogeneses of the neuropathies. A total of 88 diabetic patients (52 Type 1 and 36 Type 2), with a subclinical form of polyneuropathy were selected. The clinical neurophysiological examination consisted of motor and sensory nerve conduction studies, Hoffmann (H)-reflex, single fibre electromyography and static as well as dynamic pupillometry. With regard to clinical neurophysiological abnormalities, the severity of the polyneuropathy appeared to be equal in both groups. Despite the absence of clinical symptoms the neurophysiological abnormalities were pronounced and it was impossible to differentiate Type 1 diabetic patients from Type 2 diabetic patients on a clinical neurophysiology basis when correcting for differences in age, height, and duration of illness. In the Type 1 diabetic group as well as in the Type 2 diabetic group the autonomic nerve fibres and nerves in the legs were more frequently affected than the thick myelinated nerves in the arms. These findings do not support the assumption that there is a difference in the manifestation of polyneuropathy between Type 1 and Type 2 diabetic patients.     

Assessing the prevalence, monitoring and management of chronic kidney disease in patients with diabetes compared with those without diabetes in general practice.

AIMS: To compare rates of chronic kidney disease (CKD) in patients with diabetes and management of risk factors compared with people without diabetes using general practice computer records, and to assess the utility of serum creatinine and albuminuria as markers of impaired renal function. METHODS: The simplified Modification of Diet in Renal Disease (MDRD) equation was used to estimate glomerular filtration rate (eGFR) and stage of CKD. Further data were extracted to assess how effectively impaired renal function was being identified and how well potentially modifiable risk factors were being managed. The setting was 17 practices in Surrey, Kent and Greater Manchester (2003-2004). Participants were all patients with serum creatinine (SCr) recorded. RESULTS: Of the total population of 162 113, 5072 were recorded as having a diagnosis of diabetes, giving a prevalence of 3.1%. Of patients with diabetes, 31% had clinically significant CKD (defined as eGFR < 60 ml/min per 1.73 m(2); CKD stages 3-5) compared with 6.9% of those without diabetes. Only 33% of patients with diabetes at CKD stage 3 had serum creatinine > 120 micromol/l. Of patients with diabetes with eGFR < 60 ml/min per 1.73 m(2), 63% had normoalbuminuria. Considering those with eGFR 30-60 ml/min per 1.73 m(2), 42% of people with diabetes were on an ACE inhibitor compared with 25% of those without diabetes; 32% of patients with diabetes who had any record of micro- or macroalbuminuria at CKD stage 3 were taking an ACE inhibitor. Of people with diabetes and hypertension (BP > 140/80 mmHg), 26% were not prescribed any hypertensive medication, regardless of level of CKD. CONCLUSIONS: CKD is common in people with diabetes living in the community in the UK. The study found a similar rate of stage 3-5 CKD to that found previously in the USA. Currently used measures of renal function fail to identify CKD as effectively as eGFR. Risk factors for CKD and its progression are suboptimally managed.     

Increased prevalence of cardiovascular disease in Type 2 diabetic patients with non-alcoholic fatty liver disease.

AIMS: To estimate the prevalence of cardiovascular disease (CVD) in Type 2 diabetic patients with and without non-alcoholic fatty liver disease (NAFLD), and to assess whether NAFLD is independently related to prevalent CVD. METHODS: We studied 400 Type 2 diabetic patients with NAFLD and 400 diabetic patients without NAFLD who were matched for age and sex. Main outcome measures were prevalent CVD (as ascertained by medical history, physical examination, electrocardiogram and echo-Doppler scanning of carotid and lower limb arteries), NAFLD (by ultrasonography) and presence of the metabolic syndrome (MetS) as defined by the World Health Organization or Adult Treatment Panel III criteria. RESULTS: The prevalences of coronary (23.0 vs. 15.5%), cerebrovascular (17.2 vs. 10.2%) and peripheral (12.8 vs. 7.0%) vascular disease were significantly increased in those with NAFLD as compared with those without NAFLD (P < 0.001), with no differences between sexes. The MetS (by any criteria) and all its individual components were more frequent in NAFLD patients (P < 0.001). In logistic regression analysis, male sex, age, smoking history and MetS were independently related to prevalent CVD, whereas NAFLD was not. CONCLUSIONS: The prevalence of CVD is increased in patients with Type 2 diabetes and NAFLD in association with an increased prevalence of MetS as compared with diabetic patients without NAFLD. Follow-up studies are necessary to determine whether this higher prevalence of CVD among diabetic patients with NAFLD affects long-term mortality.     

The prevalence of hypercholesterolaemia and its relationship with albuminuria in insulin-dependent diabetic patients: an epidemiological study.

To assess the prevalence of hypercholesterolaemia and its relationship with metabolic control and urinary albumin excretion in Type 1 diabetic patients, all 1577 insulin-dependent patients attending the outpatient clinic at the Steno Memorial Hospital were studied. None had previously received lipid-lowering drugs. Hypercholesterolaemia, defined as plasma concentration of cholesterol above 6.4 mmol l-1 was found in 156 patients (10%) (95%) confidence intervals (CI) 8.4-11.5%) compared with 11% in the Danish background population. Compared with the normolipidaemic diabetic patients, the hyperlipidaemic patients were older (42 vs 37 years: p less than 0.001, 95% CI for difference in means 3-7 years), they had a higher glycosylated HbA1C (9.2 vs 8.6%, p less than 0.001, 95% CI for difference in means 0.4-1.3%) and their urinary albumin excretion was 32 vs 12 mg 24 h-1, p less than 0.001. Of the 1577 diabetic patients, 1084 patients (73%) had normal urinary albumin excretion (UAE less than 30 mg 24 h-1), 255 (17%) had microalbuminuria (UAE 30-300 mg 24 h-1) and 136 (9%) had overt clinical nephropathy (UAE greater than 300 mg 24 h-1). The plasma concentration of cholesterol rose significantly with increasing urinary albumin excretion; normoalbuminuric 4.78 mmol l-1 +/- 1.06 (mean +/- SD); microalbuminuric: 5.12 mmol l-1 +/- 1.23 and macroalbuminuric: 4.89 mmol l-1 +/- 1.38 (p less than 0.001). The influence of metabolic control on the plasma level of cholesterol was of only minor clinical importance.(ABSTRACT TRUNCATED AT 250 WORDS)     

Structured diabetes self-management education and its association with perceived diabetes knowledge,information, and disease distress: Results of a nationwide population-based study

ObjectiveTo evaluate, how participation in structured diabetes self-management education (DSME) programs is associated with perceived level of knowledge about diabetes, information needs, information sources and disease distress.MethodsWe included 796 ever- and 277 never-DSME participants of the population-based survey “Disease knowledge and information needs - Diabetes mellitus (2017)” from Germany. Data on perceived level of diabetes knowledge (12 items), information needs (11 items), information sources (13 items) and disease distress (2 indices) were collected. Multiple logistic regression analyses were used to examine the association of DSME-participation with these outcomes.ResultsDSME-participants showed a higher level of diabetes knowledge compared to never-DSME participants, particularly in aspects concerning diabetes in general (odds ratio 2.53; 95% confidence intervals 1.48–4.33), treatment (2.41; 1.36–4.26), acute complications (1.91; 1.07–3.41) and diabetes in everyday life (1.83; 1.04–3.22). DSME-participants showed higher information needs regarding late complications (1.51; 1.04–2.18) and acute complications (1.71; 1.71–2.48) than DSME never participants. DSME-participants more frequently consulted diabetologists (5.54; 3.56–8.60) and diabetes care specialists (5.62; 3.61–8.75) as information sources. DSME participation was not associated with disease distress.ConclusionDSME is a valuable tool for improving individual knowledge about diabetes. However, DSME should focus more on psychosocial aspects to reduce the disease burden.     

The prevalence of coronary heart disease in Type 2 diabetic patients in Italy: the DAI study

Aims Type 2 diabetes is associated with at least a twofold increase in risk of coronary heart disease (CHD). We aimed to estimate the prevalence of CHD in the population of Type 2 diabetics cared for by the Italian network of outpatient diabetic units. Methods The DAI ( D iabetes and Informatics study group, Italian A ssociation of Diabetologists, and I talian National Institute of Health) study is a multicentre cohort study of patients with Type 2 diabetes. Patients were classified as having CHD if they had: (i) a history for hospital admission for either an acute myocardial infarction (AMI) or angina; (ii) a positive ECG for prior AMI or angina; (iii) a positive history for coronary artery bypass graft; or (iv) a positive history for percutaneous transluminal coronary angioplasty. Results A cohort of 19 468 patients was analysed: 3157 patients had CHD. The majority of events (80%) had occurred after the diagnosis of diabetes and were considered in the CHD prevalence estimate. The prevalence of CHD, adjusted by age and sex, was 9.9%: 11.0% male and 9.0% female. Angina without AMI occurred in 1306 patients; this condition was more frequent in females while a documented AMI was more frequent in males. Therapeutic procedures were performed more frequently in males. A positive association with CHD was found for gender, age at visit, duration of diabetes, hypertension, relatives with CHD, tryglicerides and microvascular complications. Conclusions The prevalence of CHD in this cohort is lower than previously reported; nevertheless, patients attending the diabetic care units may not be fully representative of the general diabetic population in Italy. Revascularization is less frequent in females than in males; microvascular complications and a worse metabolic control are significantly associated with CHD.     

Cerebral abnormalities in diabetes mellitus: An ultrastructural study of the brain in early onset diabetes mellitus in the chinese hamster

Summary Brains of diabetic chinese hamsters have been compared with those of normal controls of the same age and sex. By electron microscopy vascular lesions were prominent, especially thickening and reduplication of basement membranes. Neurons were markedly altered with 1. Megamitochondria in dendrites, 2. densely fibrillar axoplasm, 3. degenerating axons and dendrites, 4. focal myelin degradation and 5. degeneration of synaptic endings on nerve cell stroma.This work was supported in part by a grant (NB 07887) from the Institute of Neurological Diseases and Stroke, NIH, Bethesda, Maryland and by a grant from the Upjohn Company.     

The high prevalence of unrecognized anaemia in patients with diabetes and chronic kidney disease: a population-based study

Background Anaemia occurs early in the course of diabetes-related chronic kidney disease (CKD). There is little evidence about the prevalence of anaemia in people with diabetes. The aim of this study was to assess the prevalence of anaemia, by stage of CKD, in the general diabetic population. Methods Haemoglobin (Hb) was measured on all glycated haemoglobin (HbA_1c) samples and the most recent (< 4 months) estimated glomerular filtration rate (eGFR) was obtained. Anaemia (at treatment level) was defined as Hb < 110 g/l or the use of erythropoetic stimulating agents (ESA). Results Twelve per cent (10–14%) of people had Hb < 110 g/l. The prevalence of anaemia increased progressively with worsening CKD. People with CKD stage 3 accounted for the largest number of people with anaemia; 18% (95% CI 13–24%) had Hb < 110 g/l. Those with eGFR < 60 ml/min/1.73 m² and not on ESA or dialysis were four (2–7) times more likely than patients with better renal function to have Hb < 110 g/l. The relation between Hb and eGFR became approximately linear below an eGFR of 83 ml/min/1.73 m², where, for every 1 ml/min/1.73 m² fall in eGFR, there was a 0.4 (0.3–0.5) g/l fall in haemoglobin. Conclusions This study demonstrates that anaemia, at levels where treatment is indicated, occurs commonly in people with diabetes and CKD stage 3 or worse. The screening for anaemia in current diabetes management should be extended.     

Chronic kidney disease prevalence and cardiovascular risk in a cohort of patients with type 2 diabetes followed for 10 years in Badajoz (Spain). An observational study

AimsTo estimate the prevalence of chronic kidney disease (CKD), their risk factors the incidence of cardiovascular and coronary events and total and cardiovascular mortality in a cohort of type 2 diabetes (T2DM) patients observed for 10 years in primary care practices in Badajoz, Spain.MethodsObservational, longitudinal study. A total of 643 patients with T2DM (mean age 64.0 years, 55.7% women), without evidence of cardiovascular disease, were studied. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m² at the beginning of the study, by applying the simplified Modification of Diet in Renal Disease (MDRD) Study formula.ResultsThe prevalence rate of CKD was 24.3%. Patients with CKD had higher percentages of coronary, cerebrovascular and cardiovascular events and higher rates of cardiovascular mortality (18.6 vs. 6.0%, p < 0.001) and total mortality (42.3 vs. 23.4%, p < 0.01), compared to patients without CKD. The Cox proportional hazards model, adjusted for age, systolic blood pressure levels, glycated haemoglobin, total cholesterol, obesity and smoking, revealed that patients with CKD had an increased risk of coronary events (HR:2.18; 95% CI:1.13?4.22, p < 0.05).ConclusionsOur study confirms a high prevalence of CKD in patients with T2DM and its relationship with the presence of cardiovascular disease.     

The extent of coronary artery disease in diabetic patients with myocardial infarction: an ECG study

In 91 non-diabetics (age 63 +/- 12, mean +/- SD, years range 31-94 years) and 85 patients with known diabetes or clearly abnormal levels of HbA1c (age 66 +/- 10 years, range 36-87 years) electrocardiograms were analysed sequentially after acute myocardial infarction (AMI). There was no significant difference in infarct site between the two groups. Generalized ischaemic change without ST elevation was seen in 33% of diabetics and 22% of non-diabetics (p greater than 0.1). In patients with transmural AMI, cardiogenic shock (CGS) was significantly commoner in diabetics (relative risk 3.1, CL 1.2-8.1) but there was no difference in the frequency of reciprocal change between the two groups. In both diabetic and non-diabetic patients the development of cardiogenic shock was more frequently associated with the presence of reciprocal change, the difference reaching significance in the diabetic group (chi 2 = 4.4, p less than 0.05). Thus cardiogenic shock in both diabetic and non-diabetic patients with AMI may be associated with the presence of extensive coronary artery disease, but differences in the prevalence of extensive disease do not explain the predisposition of diabetic patients to CGS.     

Prevalence of GORD (gastro‐oesophageal reflux disease) in Type 2 diabetes and a comparison of clinical profiles between diabetic patients with and without GORD

Aims To examine the incidence of gastro‐oesophageal reflux disease (GORD) and its associated factors in patients with Type 2 diabetes mellitus (Type 2 DM). Methods In 859 Type 2 DM outpatients, we conducted a QUEST inquiry and considered those showing a QUEST score of 4 or higher as having GORD. We surveyed clinical variables {physical findings, gender, age, duration of disease, glycated haemoglobin (HbA_1c), type of oral glucose‐lowering agent, presence or absence of insulin therapy, complications, and presence or absence of agents that may be associated with GORD [Ca channel blocker (CCB) anti‐platelet agents]} to investigate their association with the onset of GORD. Results We analysed 813 subjects, of whom 56.6% were male. The mean age was 63.7 ± 11.3 years and HbA_1c 7.2 ± 1.2%. The incidence of GORD was 29.0% (n = 221). GORD was positively correlated with body weight, body mass index (BMI) and HbA_1c. It was negatively correlated with age, serum creatinine and proportion of patients treated with pioglitazone or CCB. In addition, GORD was more common in females. The incidence of GORD was significantly higher in younger patients. Conclusions Previous studies have suggested a relationship of GORD with pioglitazone/CCB. However, the results of this study do not support this; these agents may not induce GORD.