Health Administration and Policy, George Mason University, Fairfax, Virginia, USA
VA New York Harbor Healthcare System, New York, New York, USA.
BMJ Open. 2020 Dec 4;10(12):e039489. doi: 10.1136/bmjopen-2020-039489.
The veterans administration diabetes risk (VADR) cohort facilitates studies on temporal and geographic patterns of pre-diabetes and diabetes, as well as targeted studies of their predictors. The cohort provides an infrastructure for examination of novel individual and community-level risk factors for diabetes and their consequences among veterans. This cohort also establishes a baseline against which to assess the impact of national or regional strategies to prevent diabetes in veterans.
The VADR cohort includes all 6 082 018 veterans in the USA enrolled in the veteran administration (VA) for primary care who were diabetes-free as of 1 January 2008 and who had at least two diabetes-free visits to a VA primary care service at least 30 days apart within any 5-year period since 1 January 2003, or veterans subsequently enrolled and were diabetes-free at cohort entry through 31 December 2016. Cohort subjects were followed from the date of cohort entry until censure defined as date of incident diabetes, loss to follow-up of 2 years, death or until 31 December 2018.
The incidence rate of type 2 diabetes in this cohort of over 6 million veterans followed for a median of 5.5 years (over 35 million person-years (PY)) was 26 per 1000 PY. During the study period, 8.5% of the cohort were lost to follow-up and 17.7% died. Many demographic, comorbidity and other clinical variables were more prevalent among patients with incident diabetes.
This cohort will be used to study community-level risk factors for diabetes, such as attributes of the food environment and neighbourhood socioeconomic status via geospatial linkage to residence address information.
退伍军人管理局糖尿病风险（VADR）队列促进了对糖尿病前期和糖尿病的时间和地理模式的研究，以及对其预测因素的针对性研究。该队列为检查糖尿病的新型个体和社区水平风险因素及其在退伍军人中的后果提供了基础。该队列还建立了一个基线，用于评估预防退伍军人糖尿病的国家或地区战略的影响。
VADR 队列包括美国所有 6082018 名在退伍军人事务部（VA）接受初级保健的退伍军人，他们在 2008 年 1 月 1 日之前没有糖尿病，并且在 2003 年 1 月 1 日以来的任何 5 年期间，至少有两次相隔至少 30 天的 VA 初级保健服务的无糖尿病就诊，或者随后入伍且在队列入组时无糖尿病直至 2016 年 12 月 31 日。队列受试者从队列入组日期开始随访，直至censure 定义为新发糖尿病日期、2 年随访丢失、死亡或 2018 年 12 月 31 日。
在这项超过 600 万退伍军人的队列研究中，中位随访时间为 5.5 年（超过 3500 万人年（PY）），2 型糖尿病的发病率为 26/1000PY。在研究期间，8.5%的队列失访，17.7%的队列死亡。许多人口统计学、合并症和其他临床变量在新发糖尿病患者中更为普遍。
该队列将用于研究社区水平的糖尿病风险因素，例如通过与居住地址信息的地理空间链接来研究食物环境和邻里社会经济地位等属性。
