The Fremantle Diabetes Study (FDS) was a longitudinal observational study of community-based people with diabetes from an urban postcode-defined population base of 120,097 in Fremantle, Western Australia.

Research overview

The study was led by Professor Timothy Davis at UWA.

Of 2,258 people identified with diabetes between April 1993 and July 1996, 1,426 were recruited to the study and 1,294 of these had type 2 diabetes.

At baseline, comprehensive physical, biochemical and socio-demographic data were collected from participants. Outcome data was obtained from the WA Hospital Morbidity Database and the State Death Register from January 1993 to June 2006. Cardiovascular disease (CVD) during follow-up was defined as hospitalisation for/with myocardial infarction or stroke, death from cardiac or cerebrovascular causes, or sudden death.

Five year cardiovascular disease risk calculator for type 2 diabetes

The FDS CVD risk calculator for type 2 diabetes is a presentation of the FDS model for 5-year risk of a major CVD event. The model estimates the probability of a major CVD event occurring in a given patient during the next 5 years, dependent on the patient’s risk factors.

The paper describing the development of the 5-year CVD risk calculator for type 2 diabetes was published in 2009:

W A Davis, M W Knuiman, T M E Davis. An Australian cardiovascular risk equation for type 2 diabetes: The Fremantle Diabetes Study. Internal Medicine Journal, “accepted article”; doi 10.1111/j.1445-5994.2009.01958x

The inputs to the model comprise:

• age
• sex
• HDL-cholesterol
• urinary albumin:creatinine ratio (ACR), HbA1c, prior CVD (yes/no),
• Southern European (yes/no), Indigenous Australian (yes/no).

The model is for use in usual-care patients with type 2 diabetes who should already be subject to proven interventions such as statin and aspirin therapy, smoking cessation, together with measures to increase HDL-cholesterol and ensure tight blood pressure control with consideration of use of agents that block the renin-angiotensin system, regardless of antihypertensive effect.

Download FDS_CVD_Risk_Calculator_v1.4.xls 

Definitions

The study defined:

• diabetes as clinician diagnosed diabetes during the period April 1993-July 1996.
• Cardiovascular disease at baseline as hospitalisation with/self-report of myocardial infarction, angina, coronary artery by-pass grafting/angioplasty, stroke or transient ischaemic attack.
• Cardiovascular disease during follow-up as hospitalisation for/with myocardial infarction or stroke, death from cardiac or cerebrovascular causes, or sudden death.

Limitations

Although the model was developed in patients with a broad range of age (14.8 to 96.9 years) and other input variables, the results for people at the extremes of age, HDL-cholesterol, urinary ACR and HbA1c should be viewed with caution.

The generalisability of the model to populations with type 2 diabetes outside WA is not yet known.

Acknowledgements

• Modelling by Wendy Davis, School of Medicine and Pharmacology.
• Development of the Excel calculator by Robin Mina, School of Population Health.
• Thanks are due to Richard Stevens (formerly of the Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism) and Ruth Coleman (Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism) for advice on statistical aspects.

Eligibility for the study

You are eligible to participate if:

• you have diabetes (any type) and you live in the Fremantle Hospital catchment area*
• • 6154: Alfred Cove, Booragoon, Myaree 
  • 6156: Attadale, Melville, Willagee
  • 6157: Bicton, Palmyra
  • 6158: East Fremantle
  • 6159: North Fremantle
  • 6160: Fremantle
  • 6162: Beaconsfield, South Fremantle, White Gum Valley
  • 6163: Bibra Lake, Coolbellup, Hamilton Hill, Hilton, Kardinya, North Lake, O'Connor, Samson, Spearwood
  • 6164: Atwell, Aubin Grove, Banjup, Beeliar, Hammond Park, Jandakot, South Lakes, Success, Yangebup
  • 6165: Hope Valley, Naval Base
  • 6166: Coogee, Henderson, Munster, Wattelup
    
• you participated in the original Fremantle Diabetes Study at any time between 1993 and 2001.

Study protocol

Phase II: National Health and Medical Research Council Project Study Protocol (download Phase II Study Protocol)

Fremantle Diabetes Study Phase II, Information Sheet invites you to participate in an observational study of diabetes in
people living in the primary catchment area of Fremantle Hospital.  (download Infosheet_adult.pdf)