Mather, Kieren J.Bebu, IonutBaker, ChelseaCohen, Robert M.Crandall, Jill P.DeSouza, CyrusGreen, Jennifer B.Kirkman, M. SueKrause-Steinrauf, HeidiLarkin, MaryPettus, JeremySeaquist, Elizabeth R.Soliman, Elsayed Z.Schroeder, Emily B.Wexler, Deborah J.Pop-Busui, Rodica2023-02-152023-02-152020-07Mather KJ, Bebu I, Baker C, et al. Prevalence of microvascular and macrovascular disease in the Glycemia Reduction Approaches in Diabetes - A Comparative Effectiveness (GRADE) Study cohort. Diabetes Res Clin Pract. 2020;165:108235. doi:10.1016/j.diabres.2020.108235https://hdl.handle.net/1805/31259Aims: The Glycemia Reduction Approaches in Diabetes - A Comparative Effectiveness (GRADE) trial is a randomized clinical trial comparing glycemic effects of four diabetes medications added to metformin in type 2 diabetes (T2D). Microvascular and macrovascular diseases are secondary outcomes. We evaluated the prevalence and risk factor relationships for microvascular and macrovascular complications in the GRADE cohort at study entry. Methods: Complication prevalence and risk factors were analyzed based on data from screening in all consenting participants meeting GRADE eligibility. Logistic regression and Z-statistics were used to assess risk factor relationships with complications. Results: We enrolled 5047 T2D participants [mean age 57 years; 36% female; mean known T2D duration 4 years (all < 10 years); mean HbA1c 8.0% (∼64 mmol/mol) at screening]. Urinary albumin/creatinine ratio (ACR) ≥ 30 mg/gram was present in 15.9% participants; peripheral neuropathy (by Michigan Neuropathy Screening Instrument) in 21.5%; cardiovascular autonomic neuropathy by electrocardiography-derived indices in 9.7%; self-reported retinopathy in 1.0%. Myocardial infarction ascertained by self-report or electrocardiogram was present in 7.3%, and self-reported history of stroke in 2.0%. Conclusions: In the GRADE cohort with < 10 years of T2D and a mean HbA1c of 8.0%, diabetes complications were present in a substantial fraction of participants, more so than might otherwise have been expected.en-USPublisher PolicyDiabetesComplicationsPrevalenceTreatmentComparative effectivenessPragmaticArticle