Trends in Prevalence and Incidence Rates of Type 2 Diabetes Mellitus in Medicare Population

IntroductionTo describe the incidence and compare in-hospital outcomes of community-acquired pneumonia (CAP), ventilator-associated pneumonia (VAP) and non-ventilator hospital-acquired pneumonia (NV-HAP) among patients with or without type 2 diabetes mellitus (T2DM) using propensity score matching.Research design and methodsThis was a retrospective observational epidemiological study using the 2016–2017 Spanish Hospital Discharge Records.ResultsOf 245 221 admissions, CAP was identified in 227 524 (27.67% with T2DM), VAP was identified in 2752 (18.31% with T2DM) and NV-HAP was identified in 14 945 (25.75% with T2DM). The incidence of pneumonia was higher among patients with T2DM (CAP: incidence rate ratio (IRR) 1.44, 95% CI 1.42 to 1.45; VAP: IRR 1.24, 95% CI 1.12 to 1.37 and NV-HAP: IRR 1.38, 95% CI 1.33 to 1.44). In-hospital mortality (IHM) for CAP was 12.74% in patients with T2DM and 14.16% in matched controls (p<0.001); in patients with VAP and NV-HAP, IHM was not significantly different between those with and without T2DM (43.65% vs 41.87%, p=0.567, and 29.02% vs 29.75%, p=0.484, respectively). Among patients with T2DM, older age and dialysis were factors associated with IHM for all types of pneumonia. In patients with VAP, the risk of IHM was higher in females (OR 1.95, 95% CI 1.28 to 2.96).ConclusionThe incidence rates of all types of pneumonia were higher in patients with T2DM. Higher mortality rates in patients with T2DM with any type of pneumonia were associated with older age, comorbidities and dialysis.

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The effect of sodium-glucose link transporter 2 inhibitors on heart failure end points in people with type 2 diabetes mellitus: a systematic review and meta-analysis

British Journal of Diabetes ◽

10.15277/bjd.2021.307 ◽

2021 ◽

Author(s):

Thomas Simon James Crabtree ◽

Robert EJ Ryder

Keyword(s):

Diabetes Mellitus ◽

Heart Failure ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Data Extraction ◽

Meta Analysis ◽

Incidence Rates ◽

Cardiovascular Outcomes ◽

Bias Assessment

Sodium-glucose linked transporter 2 inhibitors (SGLT2i) have been demonstrated to improve cardiovascular outcomes. In particular, SGLT2i appear to be beneficial in improving heart failure outcomes in people with and without diabetes. The aim of this review was to synthesis current evidence from randomised controlled trials (RCTs) comparing SGLT2i to placebo in adults with type 2 diabetes mellitus. The outcomes of interest were rate hospitalisation due to heart failure (primary), death due to heart failure (secondary) and incidence rates of heart failure (secondary).Methods: Searches were performed using recognised terms in MedLine, EMBASE, Pubmed and CINAHL. Studies were included if they compared an SGLT2i to inhibitor in an RCT and contained data for an outcome of interest. Studies were reviewed for inclusion by two people (TSJC and REJR) and data extraction and bias assessment were performed using a modified Cochrane’s data extraction tool and bias assessment tool. Meta-analysis of hazard ratios was performed in RevMan 5.4 using generic inverse variance and a fixed effects model where possible.Results: 2,850 records were identified of which 11 were eventually included, covering 9 clinical studies. Eight of these were suitable for meta-analysis for the outcome of hospitalisation due to heart failure – the pooled hazard ratio was found to be 0.69 (95% CI 0.63, 0.75). Interstudy heterogeneity was minimal (I2 0%) Only one study contained outcomes for death specifically due to heart failure, but its results were not significant. No current studies report incidence rates of new heart failure diagnosis.Conclusion: SGLT2is reduce the rates of hospitalisation due to heart failure in people with type 2 diabetes. This may help mediate the improvements seen in all cardiovascular outcomes, especially when assessed as a composite. More evidence is needed to support their use in reduce mortality due to heart failure and incidence rates of new heart failure in this high-risk cohort.

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PDB64 EVALUATION OF THE BURDEN OF ILLNESS OF TYPE-2 DIABETES MELLITUS IN A MEDICARE POPULATION

Value in Health ◽

10.1016/j.jval.2011.02.572 ◽

2011 ◽

Vol 14 (3) ◽

pp. A102-A103

Author(s):

M.E. Costantino ◽

F. Song ◽

J.N. Stacy ◽

M. Aagren ◽

J. Bouchard ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Burden Of Illness ◽

Medicare Population

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Effects of Aspirin or Clopidogrel on Colorectal Cancer Chemoprevention in Patients with Type 2 Diabetes Mellitus

Cancers ◽

10.3390/cancers11101468 ◽

2019 ◽

Vol 11 (10) ◽

pp. 1468 ◽

Cited By ~ 2

Author(s):

Yi-Chun Kuan ◽

Kuang-Wei Huang ◽

Cheng-Li Lin ◽

Jiing-Chyuan Luo ◽

Chia-Hung Kao

Keyword(s):

Diabetes Mellitus ◽

Colorectal Cancer ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Proportional Hazards ◽

Incidence Rates ◽

Cox Proportional Hazards ◽

Research Database

Background: The effect of clopidogrel, whose mechanism of action differs from that of aspirin, on CRC risk remains unknown. We investigated the effects of clopidogrel and aspirin, either as monotherapy or combined, on colorectal cancer (CRC) risk in patients with Type 2 diabetes mellitus (T2DM). Methods: We conducted a cohort study using Taiwan National Health Insurance Research Database. Four groups comprising 218,903 patients using aspirin monotherapy, 20,158 patients using clopidogrel monotherapy, 42,779 patients using dual antiplatelet therapy, and 281,840 nonuser matched controls were created using propensity score matching. Cox proportional hazards regression was used to evaluate the CRC risk during follow-up. Results: During the 13-year follow-up period, we found 9431 cases of CRC over 3,409,522 person-years. The overall incidence rates of CRC were 2.04, 3.45, 1.55, and 3.52 per 1000 person-years in the aspirin, clopidogrel, dual antiplatelet, and nonuser cohorts, respectively. The adjusted hazard ratios (aHRs) were 0.59 (95% confidence interval [CI], 0.56–0.61), 0.77 (95% CI, 0.68–0.87), and 0.37 (95% CI, 0.33–0.40) for the aspirin, clopidogrel, and dual antiplatelet cohorts, respectively. Dose- and duration-dependent chemopreventive effects were observed in the three cohorts.

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Meta-analysis on prevalence of cardiovascular diseases in patients with type 2 diabetes mellitus in India

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20212394 ◽

2021 ◽

Vol 7 (7) ◽

pp. 355

Author(s):

Poongothai J. Sakthivel ◽

Poornima P. ◽

Anantha Jothi S.

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Diabetes Type 2 ◽

Incidence Rates ◽

Type 2 Dm

<p class="abstract">Among various types of diabetes, type 2 diabetes mellitus (DM) is the most common type constituting 90% of the diabetic population. Out of several complications, cardiovascular disease (CVD) is predominant which leads to mortality. Various studies have reported different incidence rates of CVD in patients with type 2 DM. Hence, this meta-analysis study is aimed at determining the prevalence of CVD in patients with type 2 DM in India. In this review, studies were extracted by searching databases from PubMed, ScienceDirect, Google Scholar and Web of Science published between 2001 and 2021. The data collected from the extracted studies were analysed using comprehensive meta-analysis software which employs random effect model to combine the studies. 17 studies reviled 21.1% (95% CI: 17.9-24.7%) prevalence of cardiovascular CVDs in patients with type 2 DM in India. It is evident from literature review that women with DM are more prone CVD. If it is instituted that CVD is a major risk factor for DM in India, suitable scheme should be followed to improve the status of DM patients and should be brought to the note of hospitals.</p>

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Hypoglycemia Incidence Rates and Associated Health Care Costs in Patients with Type 2 Diabetes Mellitus Treated with Second-Line Linagliptin or Sulfonylurea After Metformin Monotherapy

Journal of Managed Care & Specialty Pharmacy ◽

10.18553/jmcp.2016.22.5.483 ◽

2016 ◽

Vol 22 (5) ◽

pp. 483-492 ◽

Cited By ~ 6

Author(s):

Aditya Raju ◽

Sharash Shetty ◽

Beilei Cai ◽

Anna O. D’Souza

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Health Care ◽

Type 2 Diabetes Mellitus ◽

Health Care Costs ◽

Incidence Rates ◽

Second Line ◽

Metformin Monotherapy ◽

Care Costs

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Pioglitazone Exposure Reduced the Risk of All-Cause Mortality in Insulin-Treated Patients with Type 2 Diabetes Mellitus

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgz026 ◽

2019 ◽

Vol 105 (3) ◽

pp. e401-e409 ◽

Cited By ~ 2

Author(s):

Fu-Shun Yen ◽

Hsiang-Chi Wang ◽

Chun-Wei Pan ◽

James Cheng-Chung Wei ◽

Chih-Cheng Hsu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Cohort Study ◽

Insulin Therapy ◽

Severity Index ◽

Incidence Rates ◽

Research Database ◽

All Cause Mortality

Abstract Context The long-term safety and benefit of pioglitazone use in combination with insulin are still uncertain. Objective This study compared the risks of all-cause mortality and major cardiovascular (CV) events between pioglitazone users and nonusers receiving insulin therapy. Design, Setting and Patients We conducted a 13-year retrospective cohort study by using data from the population-based National Health Insurance Research Database in Taiwan. A total of 20 376 patients with type 2 diabetes mellitus (T2DM) receiving insulin therapy were enrolled during 2000 to 2012. Overall, the incidence rates of all-cause mortality and CV events were compared between 2579 pioglitazone users and 2579 matched nonusers. Results After adjustment for age, sex, comorbidities, Diabetes Complications Severity Index scores, and drugs used, mortality rates were 30.26 and 15.02 per 1000 person-years for pioglitazone nonusers and users, respectively. The adjusted hazard ratio (aHR) of mortality was 0.47 (95% confidence interval [CI]: 0.38–0.58, P < 0.001) for pioglitazone users compared with nonusers. The aHRs of CV and non-CV deaths were 0.78 (95% CI: 0.51–1.19) and 0.50 (95% CI: 0.38–0.66), respectively. The aHRs of hospitalized coronary artery disease, hospitalized stroke, and incident heart failure were not significantly different between pioglitazone users and nonusers. Conclusions This nationwide cohort study demonstrated that pioglitazone use reduced the risks of all-cause mortality and non-CV death for patients with T2DM undergoing insulin therapy.

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Metformin Pharmacogenetics: Effects of SLC22A1, SLC22A2, and SLC22A3 Polymorphisms on Glycemic Control and HbA1c Levels

Journal of Personalized Medicine ◽

10.3390/jpm9010017 ◽

2019 ◽

Vol 9 (1) ◽

pp. 17 ◽

Cited By ~ 6

Author(s):

Laith AL-Eitan ◽

Basima Almomani ◽

Ahmad Nassar ◽

Barakat Elsaqa ◽

Nesreen Saadeh

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Multinomial Logistic Regression ◽

Incidence Rates ◽

P Value ◽

Nucleotide Polymorphisms ◽

Hba1c Levels

Type 2 diabetes mellitus (T2DM) constitutes a major portion of Jordan’s disease burden, and incidence rates are rising at a rapid rate. Due to variability in the drug’s response between ethnic groups, it is imperative that the pharmacogenetics of metformin be investigated in the Jordanian population. The objective of this study was to investigate the relationship between twenty-one single nucleotide polymorphisms (SNPs) in the SLC22A1, SLC22A2, and SLC22A3 genes and their effects on metformin pharmacogenetics in Jordanian patients diagnosed with type 2 diabetes mellitus. Blood samples were collected from 212 Jordanian diabetics who fulfilled the inclusion criteria, which were then used in SNP genotyping and determination of HbA1c levels. The rs12194182 SNP in the SLC22A3 gene was found to have a significant association (p < 0.05) with lower mean HbA1c levels, and this association more pronounced in patients with the CC genotype (i.e., p-value was significant before correcting for multiple testing). Moreover, the multinomial logistic regression analysis showed that SNP genotypes within the SLC22A1, SLC22A2, and SLC22A3 genes, body mass index (BMI) and age of diagnosis were significantly associated with glycemic control (p < 0.05). The results of this study can be used to predict response to metformin and other classes of T2DM drugs, making treatment more individualized and resulting in better clinical outcomes.

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Does Use of Acupuncture Reduce the Risk of Type 2 Diabetes Mellitus in Patients With Rheumatoid Arthritis? Evidence From a Universal Coverage Health Care System

Frontiers in Medicine ◽

10.3389/fmed.2021.752556 ◽

2021 ◽

Vol 8 ◽

Author(s):

Wei-Jen Chen ◽

Hanoch Livneh ◽

Chi-Hsien Chen ◽

Hui-Ju Huang ◽

Wen-Jiun Liu ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Proportional Hazards ◽

Universal Coverage ◽

Incidence Rates ◽

Cox Proportional Hazards ◽

Control Group

Objectives: Although acupuncture is often advocated for patients with rheumatoid arthritis (RA), its efficacy for type 2 diabetes mellitus (T2DM), a common metabolic disease among RA cohorts, has not yet been established. This retrospective cohort study aimed to determine the association between acupuncture use and the development of T2DM among them.Methods: Data were collected from 1999 through 2008 for individuals aged 20–70 years in the nationwide insurance database of Taiwan. From them, we extracted 4,941 subjects within newly diagnosed RA and being T2DM free at baseline. A total of 2,237 patients had ever received acupuncture, and 2,704 patients without receiving acupuncture were designated as a control group. All of them were followed to the end of 2013 to identify T2DM incidence. The Cox proportional hazards regression model was utilized to obtain the adjusted hazard ratio (HR) for acupuncture use.Results: Compared with the RA subjects without use of acupuncture, the incidence of T2DM was lower for those who received acupuncture, with the incidence rates of 24.50 and 18.00 per 1,000 person-years (PYs), respectively. After adjusting for potential confounders, use of acupuncture was significantly related to the lower T2DM risk, with the adjusted HR of 0.73 [95% confidence interval (CI) 0.65–0.86]. Those who used acupuncture for more than five sessions had the greatest benefit in lowering the susceptibility to T2DM.Conclusion: Adding acupuncture into conventional treatment for RA was found to be related to lower risk of T2DM among RA patients. Further clinical and mechanistic studies are warranted.

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