scholarly journals Decreased risk of colorectal cancer among patients with type 2 diabetes receiving Chinese herbal medicine: a population-based cohort study

2020 ◽  
Vol 8 (1) ◽  
pp. e000732
Author(s):  
Jing-Siang Jhang ◽  
Hanoch Livneh ◽  
Shu-Yi Yang ◽  
Hui-Ju Huang ◽  
Michael W Y Chan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Proportional Hazards ◽  
Herbal Medicines ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Research Database ◽  
Chinese Herbal

ObjectivesPatients with type 2 diabetes have a higher risk of colorectal cancer (CRC), but whether Chinese herbal medicines (CHMs) can reduce this risk is unknown. This study investigated the effect that CHMs have on CRC risk in patients with type 2 diabetes.Research design and methodsThis cohort study used the Taiwanese National Health Insurance Research Database to identify 54 744 patients, newly diagnosed with type 2 diabetes, aged 20–70 years, who were receiving treatment between 1998 and 2007. From this sample, we randomly selected 14 940 CHMs users and 14 940 non-CHMs users, using propensity scores matching. All were followed through 2012 to record CRC incidence. Cox proportional hazards regression was used to compute the hazard ratio (HR) of CRC by CHMs use.ResultsDuring follow-up, 235 CHMs users and 375 non-CHMs users developed CRC, incidence rates of 1.73% and 2.47% per 1000 person-years, respectively. CHM users had a significantly reduced risk of CRC compared with non-CHM users (adjusted HR=0.71; 95% CI 0.60 to 0.84). The greatest effect was in those receiving CHMs for more than 1 year. Huang-Qin, Xue-Fu-Zhu-Yu-Tang, Shu-Jing-Huo-Xue-Tang, Liu-Wei-Di-Huang-Wan, Ji-Sheng-Shen-Qi-Wan, Gan-Lu-Yin, Shao-Yao-Gan-Cao-Tang and Ban-Xia-Xie-Xin-Tang were significantly associated with lower risk of CRC.ConclusionIntegrating CHMs into the clinical management of patients with type 2 diabetes may be beneficial in reducing the risk of CRC.

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

Cancers ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 1468 ◽  
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.

scholarly journals Risk of a post-colonoscopy colorectal cancer in patients with type 2 diabetes: a Danish population-based cohort study

2021 ◽  
Vol 8 (1) ◽  
pp. e000786
Author(s):  
Frederikke Schønfeldt Troelsen ◽  
Henrik Toft Sørensen ◽  
Lars Pedersen ◽  
Rune Erichsen
Keyword(s):  
Colorectal Cancer ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Proportional Hazards ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Increased Risk ◽  
First Time

ObjectivePrevalent type 2 diabetes (T2D) is associated with an increased risk of colorectal cancer and could impair the quality of bowel preparation for colonoscopy. This may in turn increase the risk of overlooked precancerous polyps and subsequent risk of post-colonoscopy colorectal cancer (PCCRC). We investigated whether patients with T2D are at increased risk of PCCRC compared with patients without T2D.DesignWe conducted a population-based cohort study of patients with T2D and without T2D undergoing colonoscopy in Denmark (1995–2015). We investigated the risk of PCCRC by calculating >6 to 36 months cumulative incidence proportions (CIPs) treating death and colectomy as competing risks. Using Cox proportional-hazards regression analyses, we also computed HRs of PCCRC, comparing patients with T2D and non-T2D. According to the World Endoscopy Organization guidelines, we calculated PCCRC 3-year rates to estimate the proportions of T2D and non-T2D CRC patients experiencing PCCRC.ResultsWe identified 29 031 patients with T2D and 333 232 patients without T2D undergoing colonoscopy. We observed 250 PCCRCs among patients with T2D and 1658 PCCRCs among patients without T2D. The >6 to 36 months CIP after a first-time colonoscopy was 0.64% (95% CI 0.55% to 0.74%) for T2D and 0.36% (95% CI 0.34% to 0.38%) for patients without T2D. The HRs of PCCRC were 1.43 (95% CI 1.21 to 1.72) after a first-time colonoscopy and 1.18 (95% CI 0.75 to 1.85) after a second-time colonoscopy. The PCCRC 3-year rate was 7.9% for patients with T2D and 7.4% for patients without T2D.ConclusionT2D may be associated with an increased HR of PCCRC.

Temporal Trends in Cardiovascular Complications in People With or Without Type 2 Diabetes: The Fremantle Diabetes Study

2020 ◽  
Vol 105 (7) ◽  
pp. e2471-e2482 ◽  
Author(s):  
Wendy A Davis ◽  
Edward W Gregg ◽  
Timothy M E Davis
Keyword(s):  
Type 2 Diabetes ◽  
Lower Extremity ◽  
Proportional Hazards ◽  
Temporal Trends ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Lower Extremity Amputation ◽  
All Cause Mortality ◽  
Extremity Amputation

Abstract Context There is evidence that diabetes-related complications are declining but most data sources have limitations. Objective To characterize temporal changes in incidence rates (IRs) of chronic complications and mortality in well-characterized, community-based Australians. Design Longitudinal observational study. Setting Urban population. Participants Participants with type 2 diabetes from the Fremantle Diabetes Study phases I (FDS1; n = 1291 recruited 1993-1996) and II (FDS2; n = 1509 recruited 2008-2011) age-, sex,- and ZIP code-matched 1:4 to people without diabetes. Main outcome measures First hospitalizations for/with myocardial infarction (MI), stroke, heart failure (HF), lower extremity amputation, and cardiovascular disease (CVD) and all-cause mortality. Five-year IRs, IR ratios for those with versus without diabetes in FDS1 and FDS2, and IR differences (IRDs), were calculated. Results The 13,995 participants had a mean age of 64.8 years and 50.4% were males. There were lower IR ratios for MI, stroke, HF, and CVD death in FDS2 versus FDS1. IRDs for people with versus without type 2 diabetes had reduced by >50% between phases for MI, stroke, HF, lower extremity amputation, and CVD death, with no change in IRD for all-cause mortality. Within the pooled type 2 diabetes cohort, FDS2 versus FDS1 participation was an independent inverse predictor of stroke, HF, CVD death, and all-cause mortality after adjustment in Cox proportional hazards models. Conclusions Cardiovascular outcomes in Australians have improved since the 1990s, especially in type 2 diabetes. The difference in all-cause mortality between those with and without type 2 diabetes has persisted despite longer survival.

scholarly journals Incidence of Bladder Cancer in Type 2 Diabetes Mellitus Patients: A Population-Based Cohort Study

Medicina ◽  
2020 ◽  
Vol 56 (9) ◽  
pp. 441 ◽  
Author(s):  
Yueh Pan ◽  
Chia-Yi Lee ◽  
Liang-Ming Lee ◽  
Yu-Ching Wen ◽  
Jing-Yang Huang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Bladder Cancer ◽  
Type 2 Diabetes Mellitus ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Control Group ◽  
Study Group ◽  
Research Database

Background and objectives: Type 2 diabetes mellitus (T2DM) is becoming increasingly prevalent worldwide and is associated with increased incidence of kidney cancer and bladder cancer (BC). However, studies have produced conflicting results. Therefore, we retrospectively evaluated the incidence of BC in T2DM patients using the Taiwan National Health Insurance Research Database (NHIRD). Materials and Methods: We included 31,932 patients with a diagnosis of T2DM in the study group and 63,864 age- and sex-matched patients without T2DM at a ratio of 1:2 in the control group. The primary outcome was the diagnosis of BC. Cox proportional hazards regression was used to evaluate the incidence and adjusted hazard ratio (aHR) of BC in the multivariate model. Results: After a 16-year follow-up, we found that 67 BC cases occurred in the study group and 152 BC events in the non-T2DM group without a significantly higher risk (aHR: 0.842, 95% confidence interval: 0.627–1.13). Conclusions: T2DM patients do not have a higher risk of BC.

Diabetes is associated with decreased migraine risk: A nationwide cohort study

Cephalalgia ◽  
2017 ◽  
Vol 38 (11) ◽  
pp. 1759-1764 ◽  
Author(s):  
Ippazio Cosimo Antonazzo ◽  
Trond Riise ◽  
Marianna Cortese ◽  
Line Iden Berge ◽  
Anders Engeland ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Cohort Study ◽  
Educational Level ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Prescription Database

Background Results from studies on diabetes and migraine risk are conflicting, which may be due to methodological limitations. Prospective studies with long follow-up could increase our understanding of the relationship between the two diseases. Method We performed a cohort study including the whole Norwegian population alive on 01.01.2004, using prescriptions registered in the Norwegian prescription database to identify individuals developing type 1 diabetes, type 2 diabetes and migraine during follow-up (10 years). We used Cox proportional hazards regression to estimate rate ratios with corresponding 95% confidence intervals for the effect of diabetes on migraine risk, adjusting for age, sex, and educational level. Result We identified 7,883 type 1 diabetes patients and 93,600 type 2 patients during the study period. Type 1 diabetes was significantly associated with a subsequent decreased migraine risk during follow-up in the age- and sex-adjusted analyses (0.74; 0.61–0.89). Type 2 diabetes was also associated with a significantly lower migraine risk (0.89; 0.83–0.95). Further adjustment for educational level yielded similar results for both diabetes. Conclusion Both type 1 and type 2 diabetes were significantly associated with a decreased risk of migraine. This suggests that diabetes or diabetes treatment may have a protective effect on the development of migraine.

scholarly journals Body Weight Fluctuation as a Risk Factor for Type 2 Diabetes: Results from a Nationwide Cohort Study

2019 ◽  
Vol 8 (7) ◽  
pp. 950 ◽  
Author(s):  
Kye-Yeung Park ◽  
Hwan-Sik Hwang ◽  
Kyung-Hwan Cho ◽  
Kyungdo Han ◽  
Ga Eun Nam ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Risk Factor ◽  
Cohort Study ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
National Health Insurance System ◽  
Weight Fluctuation

We aimed to investigate how body weight fluctuation affects the risk of developing type 2 diabetes by conducting a nationwide cohort study. A total of 3,855,884 participants from the National Health Insurance System health check-up data from 2012 were included in this study, and follow-up continued until 2016. Body weight was measured at least thrice between 2009 and 2012. Body weight variability (BWV) was estimated using average successive variability (ASV) indices. Cox proportional hazards regression models were used to evaluate the association of BWV with the risk of type 2 diabetes using hazard ratios (HRs) and 95% confidence intervals (CIs). Body weight fluctuation was associated with a higher risk of incident diabetes after adjustment for confounders (HR 1.10, 95% CI 1.07, 1.12 in the highest BWV quartile compared to the lowest). Regardless of the weight change status, the highest ASV quartile of BWV increased the risk for diabetes. Even subjects with a normal glucose tolerance status and those aged under 65 years had a higher risk of diabetes if their body weight highly fluctuated during the follow-up years. Our results suggest that body weight variability is an independent risk factor for diabetes. It is important to pay attention to frequent body weight fluctuations.

scholarly journals Prenatal diethylstilbestrol exposure and risk of diabetes, gallbladder disease, and pancreatic disorders and malignancies

2020 ◽  
pp. 1-8
Author(s):  
Rebecca Troisi ◽  
Marianne Hyer ◽  
Linda Titus ◽  
Julie R. Palmer ◽  
Elizabeth E. Hatch ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Pancreatic Cancer ◽  
General Population ◽  
Proportional Hazards ◽  
Gallbladder Disease ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Increased Risk ◽  
Pancreatic Disorders

Abstract Prenatal diethylstilbestrol (DES) exposure is associated with increased risk of hormonally mediated cancers and other medical conditions. We evaluated the association between DES and risk of pancreatic cancer and pancreatic disorders, type 2 diabetes, and gallbladder disease, which may be involved with this malignancy. Our analyses used follow-up data from the US National Cancer Institute DES Combined Cohort Study. Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for age, sex, cohort, body mass index, smoking, and alcohol for the association between prenatal DES exposure and type 2 diabetes, gallbladder disease (mainly cholelithiasis), pancreatic disorders (mainly pancreatitis), and pancreatic cancer among 5667 exposed and 3315 unexposed individuals followed from 1990 to 2017. Standardized incidence rate (SIR) ratios for pancreatic cancer were based on age-, race-, and calendar year-specific general population cancer incidence rates. In women and men combined, the hazards for total pancreatic disorders and pancreatitis were greater in the prenatally DES exposed than the unexposed (HR = 11, 95% CI 2.6–51 and HR = 7.0, 95% CI 1.5–33, respectively). DES was not associated overall with gallbladder disease (HR = 1.2, 95% CI 0.88–1.5) or diabetes (HR = 1.1, 95% CI 0.9–1.2). In women, but not in men, DES exposure was associated with increased risk of pancreatic cancer compared with the unexposed (HR: 4.1, 95% CI 0.84–20) or general population (SIR: 1.9, 95% CI 1.0–3.2). Prenatal DES exposure may increase the risk of pancreatic disorders, including pancreatitis in women and men. The data suggested elevated pancreatic cancer risk in DES-exposed women, but not in exposed men.

scholarly journals Adding Pay-for-Performance Program to Routine Care Was Related to a Lower Risk of Depression Among Type 2 Diabetes Patients in Taiwan

2021 ◽  
Vol 9 ◽  
Author(s):  
Wei-Cheng Lian ◽  
Hanoch Livneh ◽  
Hui-Ju Huang ◽  
Ming-Chi Lu ◽  
How-Ran Guo ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Proportional Hazards ◽  
Pay For Performance ◽  
Treatment Compliance ◽  
Routine Care ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Beneficial Effects ◽  
Subsequent Risk

Background: Patients with type 2 diabetes (T2DM) often experience depression during treatment, negatively influencing their treatment compliance and clinical outcomes. Recently, the pay-for-performance (P4P) program for chronic diseases, with high-cost and high-risk feature, such as T2DM, has been implemented and has been operational for several years. Nevertheless, its effect on the risk of developing depression among T2DM cases is unknown. This study aims to explore the association of P4P use with the subsequent risk of developing depression among these patients.Methods: This cohort study used a nationwide health insurance database to identify patients 20–70 years of age newly diagnosed with T2DM who enrolled in the P4P program between 2001 and 2010. From this group, we enrolled 17,022 P4P users and then 17,022 non-P4P users who were randomly selected using propensity-score–matching. Enrolled patients were followed until the end of 2012 to record the occurrence of depression. The Cox proportional hazards regression was utilized to obtain the adjusted hazard ratio (aHR) for P4P use.Results: During the study period, a total of 588 P4P users and 1,075 non-P4P users developed depression at incidence rates of 5.89 and 8.41 per 1,000 person-years, respectively. P4P users had a lower depression risk than did non-P4P users (aHR, 0.73; 95% Confidence Interval, 0.65–0.80). This positive effect was particularly prominent in those receiving high-intensity use of the P4P program.Conclusion: Integrating P4P into routine care for patients with T2DM may have beneficial effects on curtailing the subsequent risk of depression.

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

2019 ◽  
Vol 105 (3) ◽  
pp. e401-e409 ◽  
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.

scholarly journals Prediction of a new body shape index and body adiposity estimator for development of type 2 diabetes mellitus: The Rural Chinese Cohort Study

2017 ◽  
Vol 118 (10) ◽  
pp. 771-776 ◽  
Author(s):  
Chengyi Han ◽  
Yu Liu ◽  
Xizhuo Sun ◽  
Xinping Luo ◽  
Lu Zhang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cohort Study ◽  
Body Shape ◽  
Proportional Hazards ◽  
Shape Index ◽  
Cox Proportional Hazards ◽  
Body Adiposity

AbstractTo compare the ability of a body shape index (ABSI) and body adiposity estimator (BAE) to BMI, waist circumference (WC) and waist:height ratio (WHtR) for predicting development of type 2 diabetes mellitus (T2DM) in rural adult Chinese. The prospective cohort study included 11 687 eligible participants who were free of T2DM at baseline. The risk of new-onset T2DM for ABSI, BAE, BMI, WC and WHtR quintiles was estimated by Cox proportional-hazards regression at follow-up. We also compared the power of ABSI and BAE to BMI, WC and WHtR for predicting the development of T2DM. With increasing ABSI, BAE, BMI, WC and WHtR, T2DM incidence was substantially increased (Ptrend<0·0001). After adjustment for multi-covariates, risk of T2DM was increased from the second to fifth quintile as compared with first quintile for ABSI (1·27; 95 % CI 0·95, 1·69; 1·35; 95 % CI 1·00, 1·82; 1·75; 95 % CI 1·33, 2·32 and 1·87; 95 % CI 1·40, 2·49; Ptrend<0·0001); BAE (1·82; 95 % CI 1·38, 2·41; 1·93; 95 % CI 1·38, 2·68; 2·73; 95 % CI 1·94, 3·84 and 4·18; 95 % CI 2·98, 5·87; Ptrend<0·0001); BMI (1·42; 95 % CI 1·03, 1·97; 1·62; 95 % CI 1·18, 2·23; 2·59; 95 % CI 1·92, 3·50 and 3·90; 95 % CI 2·90, 5·26; Ptrend<0·0001); WC (1·53; 95 % CI 1·08, 2·17; 1·66; 95 % CI 1·18, 2·33; 2·72; 1·97, 3·76 and 4·09; 95 % CI 2·97, 5·62; Ptrend<0·0001); and WHtR (1·40; 95 % CI 0·98, 1·99; 2·06; 95 % CI 1·47, 2·88; 2·90; 95 % CI 2·10, 4·01 and 4·22; 95 % CI 3·05, 5·85; Ptrend<0·0001). ABSI, BAE, BMI, WC and WHR were effective and comparable in discriminating cases from non-cases of T2DM. Risk of T2DM was increased with elevated ABSI and BAE, but the predictive ability for T2DM did not differ than that of BMI, WC and WHtR in a rural Chinese population.

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