scholarly journals LDL-cholesterol trajectories and statin treatment in Finnish type 2 diabetes patients: a growth mixture model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Laura Inglin ◽  
Piia Lavikainen ◽  
Kari Jalkanen ◽  
Tiina Laatikainen
Keyword(s):  
Type 2 Diabetes ◽  
Mixture Model ◽  
Ldl Cholesterol ◽  
Statin Treatment ◽  
Treatment Intensification ◽  
Growth Mixture Model ◽  
Growth Mixture ◽  
Diabetes Patients

AbstractWe aimed to identify distinct longitudinal trends of LDL-cholesterol (LDL-C) levels and investigate these trajectories’ association with statin treatment. This retrospective cohort study used electronic health records from 8592 type 2 diabetes patients in North Karelia, Finland, comprising all primary and specialised care visits 2011‒2017. We compared LDL-C trajectory groups assessing LDL-C treatment target achievement and changes in statin treatment intensity. Using a growth mixture model, we identified four LDL-C trajectory groups. The majority (85.9%) had “moderate-stable” LDL-C levels around 2.3 mmol/L. The second-largest group (7.7%) consisted of predominantly untreated patients with alarmingly “high-stable” LDL-C levels around 3.9 mmol/L. The “decreasing” group (3.8%) was characterised by large improvements in initially very high LDL-C levels, along with the highest statin treatment intensification rates, while among patients with “increasing” LDL-C (2.5%), statin treatment declined drastically. In all the trajectory groups, women had significantly higher average LDL-C levels and received less frequent any statin treatment and high-intensity treatment than men. Overall, 41.9% of patients had no statin prescribed at the end of follow-up. Efforts to control LDL-C should be increased—especially in patients with continuously elevated levels—by initiating and intensifying statin treatment earlier and re-initiating the treatment after discontinuation if possible.

Assessment of follow-up quality among type 2 diabetes patients in Madinah, Saudi Arabia

2020 ◽  
pp. 1342-1348
Author(s):  
Khalid Mohamed ◽  
Rami Alharbi ◽  
Yazeed Aljoahni ◽  
Abdulmajeed Alamri ◽  
Mohammed Saeed ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Saudi Arabia ◽  
Diabetes Patients

scholarly journals Comparative effectiveness of dulaglutide versus liraglutide in Asian type 2 diabetes patients: a multi-institutional cohort study and meta-analysis

2020 ◽  
Author(s):  
Kai-Cheng Chang ◽  
Shih-Chieh Shao ◽  
Shihchen Kuo ◽  
Chen-Yi Yang ◽  
Hui-Yu Chen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Real World ◽  
Comparative Effectiveness ◽  
Blood Pressure Reduction ◽  
Renal Functions ◽  
Diabetes Patients

Abstract Background Head-to-head comparison of clinical effectiveness between dulaglutide and liraglutide in Asia is limited. This study was aimed to assess the real-world comparative effectiveness of dulaglutide versus liraglutide. Methods We conducted a retrospective cohort study by utilizing multi-institutional electronic medical records to identify real-world type 2 diabetes patients treated with dulaglutide or liraglutide during 2016-2018 in Taiwan and followed up until 2019. Effectiveness outcomes were assessed at every three months in the one-year follow-up. Propensity score techniques were applied to enhance between-group comparability. Significant differences in changes of effectiveness outcomes between treatment groups during the follow-up were examined and further analyzed using mixed-model repeated-measures approaches. Results A total of 1,512 subjects receiving dulaglutide and 1,513 subjects receiving liraglutide were identified. At 12 months, significant HbA1c changes from baseline were found in both treatments (dulaglutide: -1.06%, p<0.001; liraglutide: -0.83%, p<0.001), with a significant between-group difference (-0.23%, 95% confidence interval: -0.38 to -0.08%, p<0.01). Both treatments yielded significant declines in weight, alanine aminotransferase level, and estimated glomerular filtration rate from baseline (dulaglutide: -1.14 kg, -3.08 U/L and -2.08 ml/min/1.73 m2, p<0.01; liraglutide: -1.64 kg, -3.65 U/L and -2.33 ml/min/1.73 m2, p<0.001), whereas only dulaglutide yielded a significant systolic blood pressure reduction (-2.47 mmHg, p<0.001). Between-group differences in changes of weight, blood pressure, and liver and renal functions at 12 months were not statistically significant. Conclusions In real-world T2D patients, dulaglutide versus liraglutide was associated with better glycemic control and comparable effects on changes of weight, blood pressure, and liver and renal functions.

scholarly journals Follow-up Study of Continuation versus Discontinuation of Home Exercise in Type 2 Diabetes Patients

2011 ◽  
Vol 23 (1) ◽  
pp. 91-96 ◽  
Author(s):  
Takuya Tamura ◽  
Kazuyuki Kida ◽  
Futoshi Suetsuna ◽  
Nobuhiko Kasai ◽  
Takako Seki
Keyword(s):  
Type 2 Diabetes ◽  
Home Exercise ◽  
Follow Up Study ◽  
Diabetes Patients

Telemedicine Influence on the Follow-Up of Type 2 Diabetes Patients

2009 ◽  
Vol 11 (7) ◽  
pp. 431-437 ◽  
Author(s):  
María I. Rodríguez-Idígoras ◽  
Jesús Sepúlveda-Muñoz ◽  
Ramón Sánchez-Garrido-Escudero ◽  
José L. Martínez-González ◽  
José L. Escolar-Castelló ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Patients

scholarly journals Statin therapy and risk of polyneuropathy in type 2 diabetes: A Danish cohort study

2020 ◽  
Author(s):  
Frederik P. Kristensen ◽  
Diana H. Christensen ◽  
Brian C. Callaghan ◽  
Johnny Kahlert ◽  
Søren T. Knudsen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Statin Therapy ◽  
Diabetic Polyneuropathy ◽  
Blood Lipid ◽  
Lipid Lowering ◽  
Study Cohort ◽  
Incident Type ◽  
Diabetes Patients

OBJECTIVE <p>Statins may reduce the risk of diabetic polyneuropathy (DPN) due to lipid-lowering and anti-inflammatory effects, but statins have also been associated with neurotoxicity. We examined whether statin therapy impacts the risk of DPN.</p> <p>RESEARCH DESIGN AND METHODS</p> <p>We identified all Danish incident type 2 diabetes patients during 2002-2016. New users initiated statins between 180 days before and 180 days after their first diabetes record, while prevalent users had initiated statins before that period. Patients were followed for incident DPN using validated hospital diagnosis codes, starting 180 days after first diabetes record. Cox proportional hazard analysis was used to compute adjusted hazard ratios (aHRs) for DPN. </p> <p>RESULTS </p> <p>The study cohort comprised 59,255 (23%) new users, 75,528 (29%) prevalent users, and 124,842 (48%) non-users; median follow-up time was 6.2 years (interquartile range 3.4-9.6). The incidence rate of DPN events per 1000 person-years was similar in new users (4.0 [95% CI 3.8-4.2]), prevalent users (3.8 [3.6-3.9]) and non-users (3.8 [3.7-4.0]). The aHR for DPN was 1.05 (0.98-1.11) in new users, and 0.97 (0.91-1.04) in prevalent users, compared with statin non-users. New users had a slightly increased DPN risk during the first year (aHR 1.31 [1.12-1.53]) which vanished after more than 2 years of follow-up. Findings were similar in on-treatment and propensity score-matched analyses, and with additional adjustment for pre-treatment blood lipid levels.</p> <p>CONCLUSION </p> <p>Statin therapy is unlikely to increase or mitigate DPN risk in type 2 diabetes patients, although a small acute risk of harm cannot be excluded.</p>

scholarly journals Triglyceride/low-density-lipoprotein cholesterol ratio is the most valuable predictor for increased small, dense LDL in type 2 diabetes patients

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Gen Ouchi ◽  
Ichiro Komiya ◽  
Shinichiro Taira ◽  
Tamio Wakugami ◽  
Yusuke Ohya
Keyword(s):  
Type 2 Diabetes ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Statin Treatment ◽  
Lipoprotein Cholesterol ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Valuable Predictor ◽  
Diabetes Patients

Abstract Background Small, dense low-density lipoprotein (sd-LDL) increases in type 2 diabetes patients and causes arteriosclerosis. Non–high-density-lipoprotein cholesterol (non–HDL-C) is thought to be useful for predicting arteriosclerosis and sd-LDL elevation; however, there are no data about whether the triglyceride /low-density-lipoprotein cholesterol (TG/LDL-C) ratio is a valuable predictor for sd-LDL. Methods A total of 110 type 2 diabetes patients with hypertriglyceridemia were analyzed. No patients were treated with fibrates, but 47 patients were treated with statins. LDL-C was measured by the direct method. LDL-migration index (LDL-MI) using electrophoresis (polyacrylamide gel, PAG) was calculated, and a value ≥0.400 was determined to indicate an increase in sd-LDL. Simple regression analyses were carried out between LDL-MI and lipid markers. Receiver operating characteristic curves of lipid markers for predicting high LDL-MI were applied to determine the area under the curve (AUC), sensitivity, specificity, and cut-off point. Results LDL-MI correlated negatively with LDL-C (P = 0.0027) and PAG LDL fraction (P < 0.0001) and correlated positively with TGs, non–HDL-C, TG/LDL-C ratio, TG/HDL-C ratio, and non–HDL-C/HDL-C ratio among all study patients. Similar results were obtained for patients analyzed according to statin treatment. The AUCs (95% confidence interval) were 0.945 (0.884-1.000) for TG/LDL-C ratio and 0.614 (0.463-0.765) for non–HDL-C in patients without statins (P = 0.0002). The AUCs were 0.697 (0.507-0.887) for TG/LDL-C and 0.682 (0.500-0.863) for non–HDL-C in patients treated with statins. The optimal cut-off point for TG/LDL-C ratio for increased LDL-MI was 1.1 (molar ratio) regardless of statin treatment. The sensitivity and specificity of the TG/LDL-C ratio (90.0 and 93.9%, respectively) were higher than those of non–HDL-C (56.7 and 78.8%, respectively) in patients without statins. Conclusions The TG/LDL-C ratio is a reliable surrogate lipid marker of sd-LDL and superior to non–HDL-C in type 2 diabetes patients not treated with statins.

scholarly journals Comparative effectiveness of dulaglutide versus liraglutide in Asian type 2 diabetes patients: a multi-institutional cohort study and meta-analysis

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Kai-Cheng Chang ◽  
Shih-Chieh Shao ◽  
Shihchen Kuo ◽  
Chen-Yi Yang ◽  
Hui-Yu Chen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Real World ◽  
Comparative Effectiveness ◽  
Blood Pressure Reduction ◽  
Renal Functions ◽  
Diabetes Patients

Abstract Background Head-to-head comparison of clinical effectiveness between dulaglutide and liraglutide in Asia is limited. This study was aimed to assess the real-world comparative effectiveness of dulaglutide versus liraglutide. Methods We conducted a retrospective cohort study by utilizing multi-institutional electronic medical records to identify real-world type 2 diabetes patients treated with dulaglutide or liraglutide during 2016–2018 in Taiwan and followed up until 2019. Effectiveness outcomes were assessed at every 3 months in the 1-year follow-up. Propensity score techniques were applied to enhance between-group comparability. Significant differences in changes of effectiveness outcomes between treatment groups during the follow-up were examined and further analyzed using mixed-model repeated-measures approaches. Results A total of 1512 subjects receiving dulaglutide and 1513 subjects receiving liraglutide were identified. At 12 months, significant HbA1c changes from baseline were found in both treatments (dulaglutide: − 1.06%, p < 0.001; liraglutide: − 0.83%, p < 0.001), with a significant between-group difference (− 0.23%, 95% confidence interval − 0.38 to − 0.08%, p < 0.01). Both treatments yielded significant declines in weight, alanine aminotransferase level, and estimated glomerular filtration rate from baseline (dulaglutide: − 1.14 kg, − 3.08 U/L and − 2.08 mL/min/1.73 m2, p < 0.01; liraglutide: − 1.64 kg, − 3.65 U/L and − 2.33 mL/min/1.73 m2, p < 0.001), whereas only dulaglutide yielded a significant systolic blood pressure reduction (− 2.47 mmHg, p < 0.001). Between-group differences in changes of weight, blood pressure, and liver and renal functions at 12 months were not statistically significant. Conclusions In real-world T2D patients, dulaglutide versus liraglutide was associated with better glycemic control and comparable effects on changes of weight, blood pressure, and liver and renal functions.

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