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CDE,LD,MS,RD
Online Mortality Risk Tool for Type 2 Diabetes
Section:  General Diabetes

By plugging in age, BMI, HDL, LDL, TG, Diastolic Blood Pressure, and Urine-albumin-to-creatinine ratio as well as Yes/No to questions about antihypertensive agents and insulin therapy, you can predict a 2 year mortality risk in people with diabetes using this Gargano Mortality Risk Score.  

Online mortality risk calculatorhttp://www.operapadrepio.it/rcalc/rcalc.php 

It is simple, free, and validated.  It is a web based risk calculator.  The calculator stratifies patients into low, medium, or high risk of dying from any cause within 2 years.  The purpose is to help prioritize the use of available resources for targeting aggressive preventative and treatment strategies in a sub-set of very high-risk individuals.

The researchers developed their model based on data from 679 patients in the Gargano Mortality Study who were followed from 7.4 years.  

The model was validated using data from 936 patients in the Foggia Mortality trial, who were followed for 4.5 years.  

Higher mortality risk was predicted by elevated age, urine-albumin-to-creatinine ratio, and LDL cholesterol as well as taking insulin therapy or being on antihypertensive treatement.  Lower mortality risk was predicted by elevated HDL, BMI, and diastolic blood pressere. 

In the validation study, the overall mortality risk score was from 0 to 1 with a mean of 0.53.  They put the scoresinto three risk categories: low (0.67 or less), intermediate (0.68-0.79), and high (0.80 or more).  At 2 years, those with medium risk scores were 7 times more likely to have died than those with low risk scores and those with high risk scores were 24 more times more likely to have died than those with low risk scores.

The researchers warn that the model should be tested in other populations of diabetes patients to validate its generalizability since the studies to develop it and then validate it were conducted primarily in white, Italian populations.

MEMBER COMMENTS
Re: Online Mortality Risk Tool for Type 2 Diabetes

So what would the treatment plan changes be then?  I'm often struck by the FEAR that people have when it comes to managing diabetes.  Some people have so much fear it imobilizes them and then there are others that it just moves them to change everything and then others....leave it in God's hands....

 

 

Re: Online Mortality Risk Tool for Type 2 Diabetes

I was interested in finding out more about fear and its role in motivating people to make behavior changes after reading your comments Joan. I found this interesting article:  www.mnt.ee/public/Fear.pdf

 

This is from the abstract:  The meta-analysis suggests that strong fear appeals produce high levels of perceived severity and susceptibility, and are more persuasive than low or weak fear appeals. The results also indicate that fear appeals motivate adaptive danger control actions such as message acceptance and maladaptive fear control actions such as defensive avoidance or reactance. It appears that strong fear appeals and high-efficacy messages produce the greatest behavior change, whereas strong fear appeals with low-efficacy messages produce the greatest levels of defensive responses.

 

The authors list 5 recommendations:

 

1.  Personalize the threat and describe it in specific, vivid terms.

 

2.  Messages that make potential health effects severe and threatening are the most motivating.

 

3.  Strong fear messages work only when combined with strong self-efficacy messages. When people believe that they have the ability to make positive changes and that these changes are affective, they're more likely to follow through.

 

4.  There don't seem to be individual demographic differences in our fear response.

 

5.  Both danger control responses such as attitude, intention and behavior changes and fear control responses such as denial defensive avoidance, and reactance s hould be assessed in evaluations.

The researchers bottom line: 

Fear appears to be a great motivator as long as individuals believe they are able to protect themselves.

Re: Online Mortality Risk Tool for Type 2 Diabetes

THanks Lynn, for searching this out further!  I wish I could tell which ones were which?!