US veterans administration diabetes risk (VADR) national cohort: Cohort profile

Sanja Avramovic, Farrokh Alemi, Rania Kanchi, Priscilla M. Lopez, Richard B. Hayes, Lorna E. Thorpe, Mark D. Schwartz

Research output: Contribution to journalArticlepeer-review


Purpose 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. Participants 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. Findings to date 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. Future plans 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.

Original languageEnglish (US)
Article numbere039489
JournalBMJ open
Issue number12
StatePublished - Dec 4 2020


  • epidemiology
  • general diabetes
  • health informatics

ASJC Scopus subject areas

  • General Medicine


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