Cardiovascular events and mortality among type 2 diabetes mellitus patients newly prescribed first-line blood glucose-lowering drugs monotherapies: A population-based cohort study in the Catalan electronic medical record database, SIDIAP, 2010-2015

Author(s):  
Raquel Herrera Comoglio ◽  
Xavier Vidal Guitart
Author(s):  
Najla Shamsi

Type 2 Diabetes Mellitus is a prevalent chronic disease with several macrovascular and microvascular complications. Cardiovascular diseases including coronary artery disease and stroke are common macrovascular complication that reduces the quality of life and lead to early mortality. Additionally, they pose enormous socioeconomic burden on the societies and the governments. Therefore, any intervention that reduces the cardiovascular events in patients with diabetes will have positive impact of the patients and the society. Thus, this systematic review aimed to evaluate the cardiovascular events after metabolic surgery in comparison with the new classes of glucose lowering agents in patients with type 2 diabetes mellitus. The review included 11 randomized controlled trials to both GLP-1 RA and SGLT-2 i groups. It also included 7 metabolic surgery studies, 2 of these are randomized controlled trials and the other 5 are observational studies. These studies were the most relevant studies to the research question. The results revealed different baseline demographic and clinical characteristics between the medication trials and metabolic surgery studies. Moreover, it revealed significant reduction in cardiovascular events in metabolic surgery studies when compared to medication trials. It also showed significant HbA1c and weight reduction in the metabolic surgery group. The remission of diabetes was very high in the metabolic surgery group while none of medication trials accomplished diabetes recovery. However, both medication and surgery groups had adverse events. In conclusion, the review is consistent with previous literature. It suggests that metabolic surgery is more effective than medical therapy in reducing cardiovascular events. Although this conclusion should be interpreted with caution due to the differences in baseline characteristics between studies. In general, the review recommends younger adult diabetic patients with obesity and history of established cardiovascular diseases to undergo metabolic surgery. Whereas, older patients with history of cardiovascular disease should be advised to take one of the medications that has been proved to reduce cardiovascular events. Future studies that compare metabolic surgery and the new classes of the glucose lowering agents is recommended to confirm the findings in this review.


2021 ◽  
Author(s):  
Betlem Salvador-González ◽  
Oriol Cunillera-Puértolas ◽  
David Vizcaya ◽  
M Jesus Cerain-Herrero ◽  
Neus Gil-Terrón ◽  
...  

Abstract Introduction and objectives. Chronic Kidney Disease (CKD) entails a considerable burden of adverse outcomes. Identifying the cause is recommended but data on its prognostic value are scarce. We aimed to estimate how the clinical, cardiovascular events (CVE) and all-cause mortality (ACM) of CKD patients differs according to previous Type 2 Diabetes Mellitus (2TD) and/or Hypertension (HTN). Methods. We conducted a retrospective cohort study based on electronic health records of subjects aged 18–90 years old, with incident CKD between 1st January 2007 and 31st December 2017. The association between CKD groups according to previous T2D and/or HTN, and risk of ACM and CVE at follow-up were determined with Cox and Fine-Gray regressions, respectively. Results. 398,477 subjects were included. Median age was 74years, 55.2% were women. Individuals were distributed to HTN-CKD (51.9%), T2D-CKD (3.87%), HTN/T2D-CKD (31.4%) and unspecified-CKD (12.9%). In the multivariate analysis, with the T2D-CKD group as reference, the ACM Hazard Ratio (HR) was 0.645 (95%CI 0.624–0.667) in HTN-CKD, 0.704 (95%CI 0.682–0.728) in HTN/T2D-CKD and 0.875 (95%CI 0.844–0.908) in Unspecified-CKD group. The respective sub distribution HRs for CVE were 1.006 (CI95% 0.946–1.069), 1.238 (CI95% 1.164–1.316) and 0.722 (CI95% 0.665–0.785). Conclusion. In individuals with CKD, the risk of ACM and CVE differed according to previous HTN or/and T2D. These characteristics can help identifying individuals at higher risk of adverse outcomes, and improving the management of CKD patients in primary care.


Author(s):  
Hui-Ju Tsai ◽  
Chia-Ying Li ◽  
Wen-Chi Pan ◽  
Tsung-Chieh Yao ◽  
Huey-Jen Su ◽  
...  

This study determines whether surrounding greenness is associated with the incidence of type 2 diabetes Mellitus (T2DM) in Taiwan. A retrospective cohort study determines the relationship between surrounding greenness and the incidence of T2DM during the study period of 2001–2012 using data from the National Health Insurance Research Database. The satellite-derived normalized difference vegetation index (NDVI) from the global MODIS database in the NASA Earth Observing System is used to assess greenness. Cox proportional hazard models are used to determine the relationship between exposure to surrounding greenness and the incidence of T2DM, with adjustment for potential confounders. A total of 429,504 subjects, including 40,479 subjects who developed T2DM, were identified during the study period. There is an inverse relationship between exposure to surrounding greenness and the incidence of T2DM after adjustment for individual-level covariates, comorbidities, and the region-level covariates (adjusted HR = 0.81, 95% CI: 0.79–0.82). For the general population of Taiwan, greater exposure to surrounding greenness is associated with a lower incidence of T2DM.


Author(s):  
Sultan Ayoub Meo ◽  
Abdulelah Adnan Abukhalaf ◽  
Ali Abdullah Alomar ◽  
Omar Mohammed Alessa ◽  
Omar Yassin Sumaya ◽  
...  

Sports offer great benefits, improving health and reducing the risk of illnesses. This study’s aim was to investigate the prevalence of prediabetes and type 2 diabetes mellitus in football players compared to population based non-elite athlete control subjects. Initially 1100 male volunteers, (550) football players, and (550) population based non-elite athlete control subjects were interviewed. After socio-demographic and medical history analysis, 756 (378) nonsmoker male football players and (378) nonsmoker male control subjects were recruited. The control subjects were not involved in regular sports activities such as football, volleyball, badminton, cricket, hockey, and swimming. Participants with a known history of anemia, blood diseases, diabetes mellitus, and malignancy were excluded from the study. The mean age of football players was 31.80 ± 5.46 years, Body Mass Index (BMI) was 26.40 ± 2.08 (kg/m2), and the mean age of control subjects was 32.32 ± 4.37 years, and BMI was 26.66 ± 1.87 (kg/m2). The selected football players have been playing football for about 2 h a day, 3 days per week, and so the total mean duration of playing football was 1.08 years. American Diabetes Association (ADA) based criteria on Glycated Hemoglobin (HbA1c) was used to investigate prediabetes and type 2 diabetes mellitus. In football players the prevalence of prediabetes was 30 (7.93%) and type 2 diabetes mellitus (T2DM) was 6 (1.59%) compared to population based matched non-elite athlete control subjects where the prediabetes was 71 (18.78%) and T2DM was 89 (23.54%) (p = 0.001). Among football players there was a 7-fold decrease in T2DM compared to control subjects. Football recreational activities markedly reduce the prevalence of prediabetes and T2DM. The study findings demonstrate the benefits of football and other such sport activities and emphasize the urgent need for promoting football based physical activities as a physiological preventive strategy against the globally growing diabetes epidemic.


2021 ◽  
Vol 160 (6) ◽  
pp. S-30
Author(s):  
Frederikke Sch⊘nfeldt Troelsen ◽  
Henrik Toft S⊘rensen ◽  
Lars Pedersen ◽  
Rune Erichsen

Sign in / Sign up

Export Citation Format

Share Document