scholarly journals Diet Beverage Intake and Risk of Chronic Kidney Disease in People with Type 2 Diabetes: An Individual Level Meta-Analysis

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1467-1467
Author(s):  
Andrew Odegaard ◽  
David Jacobs ◽  
Lyn Steffen ◽  
Casey Rebholz ◽  
Katherine Tucker ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Healthy Eating Index ◽  
Cardiovascular Health Study ◽  
Individual Level ◽  
Increased Risk

Abstract Objectives Diet beverages are calorie free beverages sweetened with non-nutritive sweeteners. People with diabetes are the highest per-capita consumers of diet beverages, tending to consume them as a replacement for sugar sweetened beverages. This behavior is endorsed by dietetic and scientific organizations and diet beverages are marketed synonymously with better health. The underlying concern is the lack of data to support or refute this concept. To begin addressing this gap we examined the association between diet beverage intake and incident chronic kidney disease (CKD) in a population at high risk for CKD. Methods We pooled data from the Atherosclerosis Risk in Communities study (years 1987–2014), Cardiovascular Health Study (1989–2014), Jackson Heart Study (2000–2012), and Multi-Ethnic Study of Atherosclerosis (2000–2013) to conduct a prospective study of the association of diet beverage intake with the incidence of CKD among participants with clinically ascertained type 2 diabetes (T2D) without prevalent CKD and with valid dietary data (n = 3250). CKD was defined using serum creatinine to define estimated glomerular filtration (eGFR) via the CKD-EPI creatinine equation. Incident CKD was defined as (eGFR <60 ml/min/1.73 m2). We carried out a 2-step meta-analysis using individual level, cohort-specific regression analyses with identical adjustment for demographic, lifestyle, overall diet quality (Alternative Healthy Eating Index), energy intake, and clinical risk factors (baseline eGFR, total cholesterol, blood pressure, fasting glucose) to generate effect estimates that were pooled together using fixed and random effects meta-analysis. Results 1018 participants developed CKD during follow-up. There was a positive association between diet beverage intake and risk of CKD. Compared to individuals reporting no intake of diet beverages, those consuming >0 and <1 diet beverage per day had a pooled relative risk and 95% confidence interval (RR, 95% CI) of 1.03 (0.87–1.22) and those consuming ≥1 beverage per day had a pooled RR (95% CI) of 1.20 (1.02–1.41). Conclusions Diet beverage intake was associated with an increased risk of CKD in a diverse population with T2D. These results suggest the need to further examine the role of diet beverages in this high risk population. Funding Sources AHA.

scholarly journals Association of leukocyte telomere length with chronic kidney disease in East Asians with type 2 diabetes: A Mendelian randomization study

2021 ◽  
Author(s):  
Resham L Gurung ◽  
Rajkumar Dorajoo ◽  
Yiamunaa M ◽  
Ling Wang ◽  
Sylvia Liu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Telomere Length ◽  
Mendelian Randomization ◽  
Random Effect ◽  
Leukocyte Telomere Length ◽  
Increased Risk ◽  
Genetically Determined

Abstract Background Chronic kidney disease (CKD) is common among type 2 diabetes (T2D) and increases the risk of kidney failure and cardiovascular diseases. Shorter leukocyte telomere length is associated with CKD in patients with T2D. We previously reported single nucleotide polymorphisms (SNPs) associated with leukocyte telomere length in Asian population. In this study, we elucidated the association of these SNPs with CKD in patients with T2D using Mendelian randomization (MR) approach. Methods The cross-sectional association of 16 leukocyte telomere length SNPs with CKD, defined as an estimated glomerular filtration rate of less than 60 ml/min/1.73m2 was assessed among 4,768 (1,628 cases, 3,140 controls) participants in the Singapore Study of Macro-angiopathy and Micro-vascular Reactivity in Type 2 Diabetes and Diabetic Nephropathy cohorts. MR analysis was performed using the random-effect inverse-variance weighted (IVW) method, the weighted median, MR-Egger and Radial MR adjusted for age and sex-stratified by cohorts and ethnicity (Chinese and Malays), then meta-analysed. Results Genetically determined shorter leukocyte telomere length was associated with increased risk of CKD in patients with T2D (meta-IVW adjusted odds ratio = 1.51 [95% confidence interval, 1.12 - 2.12; P = 0.007; Phet= 0.547]). Similar results were obtained following sensitivity analysis. MR-Egger analysis (intercept) suggested no evidence of horizontal pleiotropy (β  =  0.010, P = 0.751). Conclusions Our findings suggest that genetically determined leukocyte telomere length is associated with CKD in patients with T2D. Further studies are warranted to elucidate the causal role of telomere length in CKD progression.

MO817ALDOSTERONE ANTAGONISTS FOR PATIENTS WITH CHRONIC KIDNEY DISEASE REQUIRING DIALYSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Takeshi Hasegawa ◽  
Hiroki Nihiwaki ◽  
Erika Ota ◽  
William Levack ◽  
Hisashi Noma
Keyword(s):  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Standard Care ◽  
Meta Analysis ◽  
Cardiovascular Death ◽  
Aldosterone Antagonists ◽  
Mortality And Morbidity ◽  
Risk Of Death ◽  
Increased Risk

Abstract Background and Aims Patients with chronic kidney disease (CKD) undergoing dialysis are at a particularly high risk of cardiovascular mortality and morbidity. This systematic review and meta-analysis aimed to evaluate the benefits and harms of aldosterone antagonists, both non-selective (spironolactone) and selective (eplerenone), in comparison to control (placebo or standard care) in patients with CKD requiring haemodialysis or peritoneal dialysis. Method We searched the Cochrane Kidney and Transplant Register of Studies up to 29 July 2019 using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Register Search Portal and ClinicalTrials.gov. We included individual and cluster randomised controlled trials (RCTs), cross-over trials, and quasi-RCTs that compared aldosterone antagonists with placebo or standard care in patients with CKD requiring dialysis. We used a random-effects model meta-analysis to perform a quantitative synthesis of the data. We used the I2 statistic to measure heterogeneity among the trials in each analysis. We indicated summary estimates as a risk ratio (RR) for dichotomous outcomes with their 95% confidence interval (CI). We assessed the certainty of the evidence for each of the main outcomes using the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) approach. Results We included 16 trials (14 parallel RCTs and two cross-over trials) involving a total of 1,446 patients. Among included studies, 13 trials compared spironolactone to placebo or standard care and one trial compared eplerenone to a placebo. Most studies had an unclear or high risk of bias. Compared to control, aldosterone antagonists reduced the risk of all-cause death for patients with CKD requiring dialysis (9 trials, 1,119 patients: RR 0.45, 95% CI 0.30 to 0.67; moderate certainty of evidence). Aldosterone antagonist also decreased the risk of death due to cardiovascular disease (6 trials, 908 patients: RR 0.37, 95% CI 0.22 to 0.64; moderate certainty of evidence) and cardiovascular and cerebrovascular morbidity (3 trials, 328 patients: RR 0.38, 95% CI 0.18 to 0.76; moderate certainty of evidence). While aldosterone antagonists had an apparent increased risk of gynaecomastia compared with control (4 trials, 768 patients: RR 5.95, 95% CI 1.93 to 18.3; moderate certainty of evidence), the elevated risk of hyperkalaemia due to aldosterone antagonists was uncertain (9 trials, 981 patients: RR 1.41, 95% CI 0.72 to 2.78; low certainty of evidence). Conclusion Based on moderate certainty of the evidence, aldosterone antagonists could reduce the risk of all-cause and cardiovascular death and morbidity due to cardiovascular and cerebrovascular disease but increase the risk of gynaecomastia in patients with CKD requiring dialysis.

Abstract P255: Association of Mild Chronic Kidney Disease with Venous Thromboembolism: Pooled Analysis of Prospective General Population Cohorts

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Bakhtawar K Mahmoodi ◽  
Ron T Gansevoort ◽  
Inger Anne Naess ◽  
Pamela L Lutsey ◽  
Sigrid K Braekkan ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Venous Thromboembolism ◽  
Kidney Disease ◽  
General Population ◽  
Cox Regression ◽  
Meta Analysis ◽  
Random Effect ◽  
Pooled Analysis ◽  
Individual Level ◽  
Increased Risk

Background: Recent findings suggest that mild chronic kidney disease (CKD) might be associated with increased risk of venous thromboembolism (VTE). However, results were partially inconsistent, which may be due to lack of power. We therefore performed a meta-analysis to investigate the association between mild CKD and VTE incidence. Methods: A literature search was performed to retrieve community-based cohorts with information on the association of estimated glomerular filtration rate (eGFR) and albuminuria with VTE. Five cohorts were identified that were pooled on individual level. To obtain pooled hazard ratios (HRs) for VTE, linear spline models were fitted using Cox regression with shared-frailty. Models were adjusted for age, sex, hypertension, total cholesterol, smoking, diabetes, history of cardiovascular disease and body-mass index. Random-effect meta-analysis was used to obtain adjusted pooled HRs of VTE with CKD versus no CKD. Results: The analysis included 95,154 participants with 1,178 VTE cases and 599,453 person-years of follow-up. Risk of VTE increased continuously with lower eGFR and higher ACR (Figure). Compared with eGFR 100 mL/min/1.73m², pooled adjusted HRs for VTE were 1.3 (1.0–1.7) for eGFR 60, 1.8 (1.3–2.6) for 45 and 1.9 (1.2–2.9) for 30 mL/min/1.73m². Compared with albumin-creatinine ratio (ACR) 5 mg/g, pooled adjusted HRs for VTE were 1.3 (1.04–1.7) for ACR 30, 1.6 (1.1–2.4) for 300 and 1.9 (1.2–3.1) for 1000 mg/g. There was no evidence for interaction between eGFR and ACR (P=0.22). The pooled adjusted HR for CKD (eGFR <60 ml/min/1.73m² or albuminuria ≥30 mg/g) vs. no CKD was 1.5 (95%CI, 1.2–2.1). Results were similar for idiopathic and provoked VTE. Conclusion: Both reduced eGFR and elevated albuminuria are novel independent predictors of VTE in the general population.

scholarly journals TO001EFFECTS OF THE BET-INHIBITOR APABETALONE ON CARDIOVASCULAR EVENTS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS AND ACUTE CORONARY SYNDROME, ACCORDING TO PRESENCE OR ABSENCE OF CHRONIC KIDNEY DISEASE. A BETONMACE TRIAL REPORT

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Kam Kalantar-Zadeh ◽  
Kausik K Ray ◽  
Stephen J Nicholls ◽  
Henry N Ginsburg ◽  
Kevin A Buhr ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Acute Coronary Syndrome ◽  
High Risk ◽  
Kidney Disease ◽  
Myocardial Infarct ◽  
Double Blind ◽  
Coronary Syndrome ◽  
Ckd Stage

Abstract Background and Aims Patients with type 2 diabetes (T2D) and acute coronary syndrome (ACS) are at high risk for recurrent cardiovascular (CV) events, particularly in the presence of chronic kidney disease (CKD). Apabetalone (APB) is a novel inhibitor of bromodomain and extraterminal (BET) proteins. Its cardiovascular efficacy and safety were evaluated in a phase 3 trial, BETonMACE. Method BETonMACE was a randomized, double-blind, comparison of effects of ABP or placebo (PBO) on major adverse CV events (MACE) defined as CV-death, non-fatal myocardial infarct or stroke, in 2425 pts with T2D and recent ACS. Here we report MACE plus CHF hospitalization in subjects with or without CKD Stage 3. Results Baseline characteristics: median age 62 years, 25.6% female, 87.6% white, 90% high intensity statin use, mean LDL-C 70.3 and HDL-C 33.3 mg/dl, median HbA1c 7.3%, and 11% with CKD Stage 3. Overall in the trial, MACE plus CHF hospitalization occurred in 139 (11.5%) patients with ABP and 173 (14.3%) with PBO (HR 0.78, 95% CI 0.63-0.98). In the subgroup with CKD, MACE plus CHF hospitalization occurred in 16 (12.9%) on APB and 41 (25%) on PBO (HR 0.48, 95% CI 0.26-0.89). In the subgroup without CKD, MACE plus CHF hospitalization occurred in 123 (11.3%) and 132 (12.7%) with APB or PBO, respectively (HR 0.89, 95% CI 0.70-1. Conclusion Patients with T2D, ACS, and Stage 3 CKD have a very high risk of subsequent MACE plus CHF hospitalization. The BET protein inhibitor ABP may reduce this risk.

scholarly journals P1011CARDIOVASCULAR OUTCOME TRIALS (CVOT) USING NEW ANTI-DIABETIC AGENTS IN CHRONIC KIDNEY DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Nadia Sarween ◽  
Nuvreen Phagura ◽  
Adnan Sharif
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Second Line ◽  
Second Line Therapy ◽  
Receptor Agonists ◽  
Line Therapy

Abstract Background and Aims The latest consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) recommends metformin and lifestyle intervention as first-line therapy for type 2 diabetes. Second-line therapy recommendation is the use sodium-glucose cotransporter 2 (SGLT 2) inhibitors (if estimated glomerular filtration rate [eGFR] is adequate) or GLP-1 receptor agonists if eGFR is inadequate (or SGLT-2 inhibitors not tolerated). No recommendation is made for dipeptidyl peptidase-4 (DPP-4) inhibitors. Therapy choices are limited for patients with both type 2 diabetes and moderate-to-severe chronic kidney disease (CKD) and it is unclear from published data if observed cardiovascular benefits of new anti-diabetic agents extend to the CKD cohort. The aim of this study was to undertake a systematic review of all published CVOT trials using new anti-diabetic agents (GLP-1 receptor agonist, DPP-4 inhibitor, SGLT 2 inhibitor). Method We searched MEDLINE (via PubMed and the Cochrane Central Register of Controlled Trials) up to 1st December 2019. Data was stratified by trial entry eGFR into normal (eGFR ≥60 ml/min) and CKD (eGFR &lt;60 ml/min), with data extracted for primary major cardiovascular event (MACE) rates such as cardiovascular death, stroke and/or myocardial infarct. A meta-analysis with random effects model was performed to estimate overall hazard ratios (HRs) for MACE with new anti-diabetic agents stratified by eGFR. Inter-study heterogeneity was assessed with the I2 index and Cochran’s Q test. Results We analysed 13 studies from 16 that were eligible after our search strategy, with 2 excluded due lack of data stratified by eGFR and 1 excluded due to combined MACE/renal outcomes. The studies (GLP-1 agonists, n=6; DPP-4 inhibitors, n=4; SGLT 2 inhibitors, n=3) had a combined total of 128,266 participants (22.1% with eGFR &lt;60 ml/min). HR for MACE with GLP-1 agonists for participants with eGFR ≥60 ml/min was 0.87 (95% CI 0.77-0.98; p=0.02) and for participants with eGFR &lt;60 ml/min was 0.90 (95% CI 0.78-1.04; p=0.14). HR for MACE with DPP-4 inhibitors for participants with eGFR ≥60 ml/min was 0.99 (95% CI 0.92-1.07; p=0.86) and for participants with eGFR &lt;60 ml/min was 0.99 (95% CI 0.91-1.08; p=0.86). HR for MACE with SGLT 2 inhibitors for participants with eGFR ≥60 ml/min was 0.98 (95% CI 0.88-1.10; p=0.78) and for participants with eGFR &lt;60 ml/min was 0.82 (95% CI 0.70-0.96; p=0.01). Significant heterogeneity was observed in the meta-analyses for each new anti-diabetic therapy drug class stratified by eGFR. Conclusion Among the new anti-diabetic agents, our study suggests efficacy for prevention of MACE in the setting of CKD exists only for SGLT 2 inhibitors and not with GLP-1 receptor agonists or DPP-4 inhibitors. Targeted CVOT studies incorporating participants with diabetes and CKD are critical to guide glycaemic management in these high-risk patients. Until then, we suggest recommendations for second-line therapy in patients with type 2 diabetes and renal impairment should be amended to reflect the current evidence base supporting prevention of MACE with SGLT 2 inhibitors versus other new anti-diabetic agents.

scholarly journals The burden of unrecognised chronic kidney disease in patients with type 2 diabetes at a county hospital clinic in Kenya: implications to care and need for screening.

2019 ◽  
Author(s):  
Frederick C. F. Otieno ◽  
Elijah N Ogola ◽  
Mercy W Kimando ◽  
Ken K Mutai
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
County Hospital ◽  
End Stage Kidney Disease ◽  
Long Duration ◽  
End Stage

Abstract Background: Chronic Kidney Disease (CKD) in patients with type 2 diabetes enhances the cardiovascular risk profiles and disease, and is a strong predictor of progression to end-stage kidney disease. Early diagnosis is encouraged for referral to specialist kidney care to initiate active management that would optimize outcomes including forestalling progression to end-stage kidney disease. This study was conducted in a regional referral public health facility in Central Kenya with a high prevalence of type 2 diabetes. It was aimed at finding out the burden of undiagnosed chronic kidney disease in their clinic of ambulatory patients with type 2 diabetes who dwell mainly in the rural area. Methods: A cross-sectional study was conducted at the out-patient of Nyeri County hospital. A total of 385 patients were enrolled over five months. Informed consent was obtained and clinical evaluation was done, a spot sample of urine obtained for albuminuria and venous blood drawn for HbA1c, Lipids and serum creatinine. Estimated GFR (eGFR) was calculated using the Cockroft-Gault equation. Chronic kidney disease (CKD) was classified on KDIGO scale. Albuminuria was reported as either positive or negative. Main outcomes measure: Estimated Glomerular filtration rate and albuminuria as markers of chronic kidney disease. Results: A total of 385 participants were included in the study, 252 (65.5%) were females. There were 39.0 % (95%CI 34.3-44.2) patients in CKD/KDIGO stages 3, 4 and 5 and 32.7% (95%CI, 27.8-37.4) had Albuminuria. The risk factors that were significantly associated with chronic kidney disease/KDIGO stages 3, 4 and 5 were: age >50years, long duration with diabetes >5years and hypertension. Employment and paradoxically, obesity reduced the odds of having CKD, probably as markers of better socio-economic status. Conclusion: Unrecognized CKD of KDIGO stages 3,4 and 5 occurred in over thirty percent of the study patients. The risk factors of hypertension, age above 50, long duration of diabetes should help identify those at high risk of developing CKD, for screening and linkage to care. They are at high risk of progression to end-stage kidney disease and cardiovascular events. The imperative of screening for chronic kidney disease is availing care in publicly-funded hospitals.

scholarly journals The burden of unrecognised chronic kidney disease in patients with type 2 diabetes at a county hospital clinic in Kenya: implications to care and need for screening

2020 ◽  
Author(s):  
Frederick C. F. Otieno ◽  
Elijah N Ogola ◽  
Mercy W Kimando ◽  
Ken K Mutai
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
County Hospital ◽  
End Stage Kidney Disease ◽  
Long Duration ◽  
End Stage

Abstract Background : Chronic Kidney Disease (CKD) in patients with type 2 diabetes enhances their cardiovascular risk and diseases, and a strong predictor of progression to end-stage kidney disease. Early diagnosis is encouraged for referral to specialist kidney care to initiate active management that optimizes outcomes, including forestalling progression to end-stage kidney disease. This study was conducted in a regional referral public health facility in Central Kenya with a high prevalence of type 2 diabetes. It was aimed at finding out the burden of undiagnosed chronic kidney disease in their clinic of ambulatory patients with type 2 diabetes who dwell mainly in the rural area. Methods : A cross-sectional study was conducted at the out-patient of Nyeri County hospital where 385 patients were enrolled over five months. Informed consent was obtained and clinical evaluation was done. A spot sample of urine was obtained for albuminuria and venous blood drawn for HbA1c, Lipids and serum creatinine. Estimated GFR (eGFR) was calculated using the Cockroft-Gault equation. Chronic kidney disease (CKD) was classified on KDIGO scale. Albuminuria was reported as either positive or negative. Main outcomes measure: Estimated Glomerular filtration rate and albuminuria as markers of chronic kidney disease. Results : A total of 385 participants were included in the study, 252 (65.5%) were females. There were 39.0 % (95%CI 34.3-44.2) patients in CKD/KDIGO stages 3, 4 and 5 and 32.7% (95%CI, 27.8-37.4) had Albuminuria. The risk factors that were significantly associated with chronic kidney disease/KDIGO stages 3, 4 and 5 were: age >50years, long duration with diabetes >5years and hypertension. Employment and paradoxically, obesity reduced the odds of having CKD, probably as markers of better socio-economic status. Conclusion : Unrecognized CKD of KDIGO stages 3,4 and 5 occurred in over thirty percent of the study patients. The risk factors of hypertension, age above 50, long duration of diabetes should help identify those at high risk of developing CKD, for screening and linkage to care. They are at high risk of progression to end-stage kidney disease and cardiovascular events. The imperative of screening for chronic kidney disease is availing care in publicly-funded hospitals.

Abstract 054: Diet Beverage Intake is Positively Associated With Incident Coronary Heart Disease in People With Type 2 Diabetes

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Andrew O Odegaard ◽  
Lyn M Steffen ◽  
David R Jacobs ◽  
Katherine L Tucker ◽  
Kenneth J Mukamal ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Meta Analysis ◽  
Health Concern ◽  
Cardiovascular Health Study ◽  
High Risk Population ◽  
Incident Coronary Heart Disease ◽  
Increased Risk

Introduction: Diet beverages are calorie free beverages sweetened with non-nutritive sweeteners. People with diabetes are the highest per-capita consumers of diet beverages, tending to consume them as a replacement for dietary sources of sugar, especially in place of sugar sweetened beverages. This behavior is endorsed by dietetic and scientific organizations and diet beverages are marketed synonymously with better health, weight loss, and thus, are considered advantageous for diabetes control. The underlying public health concern is the lack of data to support or refute this concept. Hypothesis: Higher diet beverage intake is positively associated with incident Coronary Heart Disease (CHD) Methods: We pooled the data sets of the Atherosclerosis Risk in Communities (ARIC) study (1987-2014), Cardiovascular Health Study (CHS) (1989-2014), Framingham Offspring Study (FOS) (1995-2014), Jackson Heart Study (JHS) (2000-2012), and Multi-Ethnic Study of Atherosclerosis (MESA (2000-2013) to conduct a prospective examination of the association of diet beverage intake with the incidence of CHD among participants with clinically ascertained type 2 diabetes (T2D) without prevalent CHD and with valid dietary data (N=3,947). We carried out a 2-step meta-analysis using individual level, cohort-specific Cox regression analyses with identical adjustment for demographic, lifestyle, overall diet quality and clinical risk factors to generate effect estimates that were pooled together using fixed and random effects meta-analysis. Results: 1,046 participants developed adjudicated CHD during follow-up. There was a positive, graded association between diet beverage intake and risk of incident CHD (Table). Results were consistent by sex, race and age. Conclusions: Diet beverage intake is associated with increased risk of developing CHD in a population with T2D. These results suggest the need to further evaluate dietary recommendations related to diet beverages and consider their role in this high risk population.

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