scholarly journals PDB71 ASSOCIATION OF SEVERE HYPOGLYCEMIA WITH ALL-CAUSE MORTALITY AND COMPLICATIONS AMONG PATIENTS WITH DIABETES MELLITUS IN CHINA

2019 ◽  
Vol 22 ◽  
pp. S585-S586 ◽  
Author(s):  
J. Zhang ◽  
X. He ◽  
K. Wang ◽  
C. Hong ◽  
J. Wu
Keyword(s):  
Diabetes Mellitus ◽  
Severe Hypoglycemia ◽  
All Cause Mortality ◽  
Patients With Diabetes

Long-term prognosis after percutaneous or surgical revascularization in patients with diabetes mellitus and complex coronary artery disease- a systematic review and meta analysis

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
A Abdul Razzack ◽  
S Mandava ◽  
S Pothuru ◽  
S Adeel Hassan ◽  
D Missael Rocha Castellanos ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Artery Bypass ◽  
Left Main ◽  
All Cause Mortality ◽  
Patients With Diabetes ◽  
Artery Disease

Abstract Funding Acknowledgements Type of funding sources: None. Background-Whether Coronary artery bypass grafting (CABG) confers a survival benefit in patients with diabetes mellitus(DM) and complex coronary artery disease (CAD), including left main CAD and multivessel coronary disease (MVD) after a follow up period ≥ 5 years remains unknown. Methods- Electronic databases (PubMed, Embase, Scopus, Cochrane) were searched from inception to December 12th 2020. Using a generic invariance weighted random effects model, Hazard ratios (HRs) and their 95% confidence intervals (CIs) from individual studies were converted to Log HRs and corresponding standard errors, which were then pooled. The primary outcome of interest was all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE) which was defined as a composite of death, myocardial reinfarction and stroke at ≥ 5 years. Results-A total of 8 studies with 13336 participants(PCI = 6783, CABG = 6553)were included in our analysis. Mean age was 54.6 and 55.3 in the PCI-DES and CABG groups respectively. The 5-yr follow-up outcomes including all-cause mortality (HR 1.37; 95%CI 1.15-1.65; p = 0.0006, I2 = 0)and MACCE (HR 1.48; 95%CI 1.29-1.69; p < 0.00001, I2 = 0) were significantly higher with PCI as compared to CABG. Furthermore, at >5 year follow-up, all-cause mortality (HR 1.35; 95%CI 1.10-1.66; p = 0.004, I2 = 37) and MACCE (HR 1.98; 95%CI 1.85-2.12; p < 0.00001, I2 = 0) had similar outcomes. Conclusion-Amongst patients with DM and Complex CAD ( left main/MVD), CABG was associated with improved long-term mortality and freedom from MACCEs as opposed to PCI-DES. CABG is the preferred revascularization strategy in patients with complex anatomic disease and concurrent diabetes. Abstract Figure.

scholarly journals Hypoglycemias deliberately induced by insulin in diabetic children

1995 ◽  
Vol 41 (6) ◽  
pp. 27-29
Author(s):  
T. L. Kurayeva ◽  
O. V. Remizov
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Therapy ◽  
Cause Of Death ◽  
Severe Hypoglycemia ◽  
Modern Medicine ◽  
Research Centre ◽  
Munchausen Syndrome ◽  
Young Girls ◽  
Diabetic Children ◽  
Patients With Diabetes

Hypoglycemic conditions are one of the complex problems in modern medicine. Among patients with diabetes mellitus (DM), obvious and asymptomatic hypoglycemia, according to various authors, are recorded in 25–58% of patients. Asymptomatic hypoglycemia is more often observed at 3 o'clock. Severe hypoglycemia as a cause of death occurs in 0.25-0.05% of cases of insulin therapy. There are few reports of deliberately induced hypoglycemia in patients with diabetes. This is more often observed in young girls and is considered as one of the options for Munchausen syndrome. The authors observed three such patients in Endocrinology research centre, the article presents one of these cases.

scholarly journals Development of a predictive risk model for all-cause mortality in patients with diabetes in Hong Kong

2021 ◽  
Vol 9 (1) ◽  
pp. e001950
Author(s):  
Sharen Lee ◽  
Jiandong Zhou ◽  
Keith Sai Kit Leung ◽  
William Ka Kei Wu ◽  
Wing Tak Wong ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Deep Learning ◽  
Risk Model ◽  
All Cause Mortality ◽  
Patients With Diabetes ◽  
Predictive Risk

IntroductionPatients with diabetes mellitus are risk of premature death. In this study, we developed a machine learning-driven predictive risk model for all-cause mortality among patients with type 2 diabetes mellitus using multiparametric approach with data from different domains.Research design and methodsThis study used territory-wide data of patients with type 2 diabetes attending public hospitals or their associated ambulatory/outpatient facilities in Hong Kong between January 1, 2009 and December 31, 2009. The primary outcome is all-cause mortality. The association of risk variables and all-cause mortality was assessed using Cox proportional hazards models. Machine and deep learning approaches were used to improve overall survival prediction and were evaluated with fivefold cross validation method.ResultsA total of 273 678 patients (mean age: 65.4±12.7 years, male: 48.2%, median follow-up: 142 (IQR=106–142) months) were included, with 91 155 deaths occurring on follow-up (33.3%; annualized mortality rate: 3.4%/year; 2.7 million patient-years). Multivariate Cox regression found the following significant predictors of all-cause mortality: age, male gender, baseline comorbidities, anemia, mean values of neutrophil-to-lymphocyte ratio, high-density lipoprotein-cholesterol, total cholesterol, triglyceride, HbA1c and fasting blood glucose (FBG), measures of variability of both HbA1c and FBG. The above parameters were incorporated into a score-based predictive risk model that had a c-statistic of 0.73 (95% CI 0.66 to 0.77), which was improved to 0.86 (0.81 to 0.90) and 0.87 (0.84 to 0.91) using random survival forests and deep survival learning models, respectively.ConclusionsA multiparametric model incorporating variables from different domains predicted all-cause mortality accurately in type 2 diabetes mellitus. The predictive and modeling capabilities of machine/deep learning survival analysis achieved more accurate predictions.

scholarly journals Assessing cardiovascular risk in patients with diabetes: An update.

2019 ◽  
Vol 15 ◽  
Author(s):  
Christos Damaskos ◽  
Nikolaos Garmpis ◽  
Paraskevi Kollia ◽  
Georgios Mitsiopoulos ◽  
Danai Barlampa ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Risk ◽  
Severe Hypoglycemia ◽  
Diabetes Diagnosis ◽  
Alcoholic Fatty Liver ◽  
Chronic Hyperglycemia ◽  
Obstructive Sleep ◽  
Patients With Diabetes ◽  
Individualize Treatment ◽  
Alcoholic Fatty Liver Disease

: The globalization of the Western lifestyle has resulted in a dramatic increase of diabetes mellitus, a complex, multifactorial disease. Diabetes mellitus is a condition often associated with disorders of the cardiovascular system. It is well established that three quarters of diabetics, aged over 40, will die from cardiovascular disease and are more likely than non-diabetics to die from their first cardiovascular event. Therefore, risk stratification is necessary to individualize treatment. Age above 40 years, diabetes diagnosis of more than 10 years, the presence of a first degree family history with premature CHD, male gender, high blood pressure, LDL above 100 mg/dl, low renal function, microalbuminuria, presence of non-alcoholic fatty liver disease, obstructive sleep apnea, erectile dysfunction and specially metabolic syndrome, chronic hyperglycemia and severe hypoglycemia are conditions that increase cardiovascular risk. : Several models have been developed in order to assess cardiovascular risk in people with and without diabetes. Some of them have been proven to be inadequate while others are widely used for years. An emerging way of risk assessment in patients with diabetes mellitus is the use of biomarkers but a lot of research needs to be done on this field in order to have solid conclusions.

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