Association of Cardio-Ankle Vascular Index (CAVI) and Duration of Diabetes Mellitus in the STOP (Semaglutide Treatment on Coronary Plaque Progression) Randomized Control Trial

2021 ◽  
Vol 242 ◽  
pp. 170
Author(s):  
Dhiran Verghese ◽  
Venkat Sanjay Manubolu ◽  
Luay Alalawi ◽  
April Kinninger ◽  
Khadije Ahmad ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Randomized Control Trial ◽  
Coronary Plaque ◽  
Plaque Progression ◽  
Duration Of Diabetes ◽  
Randomized Control

scholarly journals A comparative study of metformin and glyburide in gestational diabetes mellitus

2017 ◽  
Vol 6 (4) ◽  
pp. 1493 ◽  
Author(s):  
Prashant Pujara ◽  
Vinita Singh ◽  
Sunita Murmu ◽  
Suman Kumari ◽  
Dhara Prajapati
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Randomized Control Trial ◽  
Neonatal Hypoglycemia ◽  
First Line ◽  
Adverse Neonatal Outcomes ◽  
Management Modality ◽  
Randomized Control

Background: Incidence of gestational diabetes mellitus (GDM) is increasing worldwide. GDM provides a window of opportunity for the primary prevention of the type 2 diabetes by preventing transgeneration transmission to fetus. Insulin in management of GDM has many drawbacks, so use of OHAs has been increased worldwide.Methods: Randomized control trial was performed in patients with GDM who required medical management. Subjects were randomized into two groups and treated with Metformin and Glyburide, results were compared.Results: While comparing efficacy of metformin and glyburide in this study for maternal variables; the failure rate of metformin was found to be 9.39 times higher compared to glyburide. Glyburide was associated with 9.5 times more risk to develop hypoglycemia in mother compared to metformin. While comparing neonatal variables nursery admission was found to be more and statistically significant in neonates whose mother has received glyburide compared to metformin (p=0.03, RR=2.26). Though statistically insignificant, LGA fetuses and neonatal hypoglycemia were 2.1 times more in glyburide group compared to metformin.Conclusions: Though glyburide can be effective alternative to metformin and insulin for GDM, it is associated with higher risk of maternal hypoglycemia, neonatal hypoglycemia, LGA fetuses and higher rate of nursery admissions compared to metformin. Higher adverse neonatal outcomes with glyburide use question the widespread use of glyburide as first line management modality in GDM and also as an alternative to insulin as advised by many groups.

scholarly journals Effect of diabetes mellitus on coronary plaque characteristics and progression by serial Coronary Computed Tomography Angiography (CCTA)

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Lakshmanan ◽  
A Kinninger ◽  
R Nakanishi ◽  
C Shekar ◽  
K Shaikh ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Plaque ◽  
Vulnerable Population ◽  
Plaque Burden ◽  
Plaque Progression ◽  
Cardiac Events ◽  
Fibrous Plaque ◽  
Funding Sources ◽  
Increased Risk ◽  
Poor Outcomes

Abstract Background Diabetes Mellitus (DM) is a major risk factor for coronary artery disease (CAD) and associated poor outcomes. There is a higher incidence of major adverse cardiac events in patients with DM than those without DM. Coronary plaque characteristics measured by CCTA are correlated with adverse cardiovascular (CV) outcomes. Purpose We sought to evaluate coronary plaque characteristics as well as rates of progression of coronary plaque burden as measured by serial CCTA in patients with DM and those without DM. Methods The study population included a total of 403 participants (mean age 61.4±11.4 years, 53% men; median scan interval 1.5 years) who were prospectively enrolled in serial CCTA trials. We identified 212 participants with DM and 191 participants without DM, who had undergone serial CCTA. Coronary Plaque volumes were measured and characterized as low attenuation plaque (LAP), total non-calcified plaque (TNCP) and total plaque (TP) using semi-automated plaque analysis software (Qangio medis). Multivariate linear regression was used to examine the effect of DM on coronary plaque progression. Results Patients with DM had greater rates of progression of normalized TP volume (median change in annualized plaque (IQR): 39.1 (9.9–114.4) in DM vs 23.5 (4.1–63.8) mm3 in non-DM, p=0.001), TNCP volume (21.6 (3.3–60.8) in DM vs 8.7 (0.1–35.6) mm3 in non-DM, p=0.003) and LAP volumes (0.7 (−0.6 to 7.8) in DM vs 0.1 (−0.4 to 1.9) mm3 in non-DM, p=0.04). After adjusting for relevant risk factors and baseline plaque, the annualized rates of progression were higher in patients with DM by 28% for TP (p=0.004), 27% for TNCP (p=0.011), 23% for fibrous plaque (p=0.026) and by 42% LAP (p=0.050), compared to those without DM. Conclusion Patients with DM have significantly higher rates of coronary plaque progression, including vulnerable LAP, than those without DM. Our findings reveal differences in rates, burden and characteristics of coronary plaque progression in patients with DM vs those without DM. These results provide mechanistic understanding of natural history of coronary atherosclerosis in this vulnerable population, that could explain the increased risk of CV events among patients with DM. Coronary atherosclerotic phenotyping by CCTA could serve as a potential surrogate measure for risk stratification and evaluation in clinical trials to examine therapeutic strategies in this vulnerable population. FUNDunding Acknowledgement Type of funding sources: None.

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