scholarly journals Population-based cross-sectional study of 11 645 Spanish nonagenarians with type 2 diabetes mellitus: cardiovascular profile, cardiovascular preventive therapies, achievement goals and sex differences

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030344
Author(s):  
Miguel Angel Salinero-Fort ◽  
Jose M Mostaza-Prieto ◽  
Carlos Lahoz-Rallo ◽  
José Ignacio Vicente Díez ◽  
Juan Cárdenas-Valladolid
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Sex Differences ◽  
Cerebrovascular Disease ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Cross Sectional ◽  
Artery Disease

ObjectivesTo evaluate the risk profile, achievement of cardiometabolic goals, and frequency and optimal use of cardiovascular preventive therapies among nonagenarians with type 2 diabetes mellitus (T2DM). To investigate possible sex differences.Design and settingA cross-sectional population study of 11 645 persons aged ≥90 years with T2DM living in Madrid (Spain). Sociodemographic, clinical and therapy profiles were collected through electronic records in primary care. We considered antihypertensive therapy and lipid-lowering therapy to be optimal when known patients with hypertension with albuminuria received renin–angiotensin system blockers and statins had been prescribed for overt cardiovascular disease.ResultsThe prevalence of coronary artery disease was higher in males than in females (21.5% vs 12.6%, p<0.01), as was that of peripheral artery disease (8.5% vs 2.3%, p<0.01). However, the prevalence of cerebrovascular disease was similar in both sexes (16.5% vs 16%; p=0.44). Haemoglobin A1c was lower than 7% in 64.4% of cases, with female predominance in patients with known dementia (67.1% female vs 59.9% male; p<0.01). Antiplatelet therapy was significantly more frequent in males than in females (48.1% vs 44.3%; p<0.01), as were statins (43.2% vs 40.2%; p<0.01). Both in primary and in secondary prevention, rates for simultaneous achievement of the HbA1c, blood pressure, LDL-C goals were significantly lower among females (p<0.01). For each criterion of optimal use of cardiovascular preventive therapies, adherence was significantly better in males than in females.ConclusionOur study showed that the risk of cerebrovascular disease was similar in both male and female Spanish nonagenarians. Adherence was poorer in females for all criteria of optimal use of cardiovascular preventive therapies. Our findings indicate that the known sex differences in younger patients with T2DM persist in patients aged ≥90 years. There is considerable room for improvement in standards of preventive care in nonagenarians with T2DM, especially in females.

scholarly journals Correlation of HbA1c with urinary ACR, serum creatinine and eGFR in type-2 diabetes mellitus at Puducherry, South India

2019 ◽  
Vol 7 (5) ◽  
pp. 1924
Author(s):  
Vithiavathi Sivasubramanian ◽  
Karthik Jetty ◽  
S. Senthil Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Serum Creatinine ◽  
Urinary Albumin ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Cross Sectional ◽  
Type 2 Dm

Background: Diabetes Mellitus (DM) is a major emerging clinical health problem in this world. Anemia is a common problem in diabetes. Type 2 DM comprises about 90% of diabetic population of any country.Methods: A cross-sectional study carried out among 125 type 2 diabetic mellitus patients’ area at Department of Medicine Aarupadai Veedu Medical college (AVMC) and hospital, Puducherry during the period from May 2018 to October 2018.The objectives of the study were to evaluate the association of HbA1c with urinary ACR, eGFR and serum creatinine in Type 2 diabetes mellitus. Data was analyzed using the SPSS version 20.0 software.Results: The randomly selected study group comprised 100 type 2 DM patients and 25 control peoples of 35-70 years of age. Type 2 DM patients were evaluated of HbA1c, normotensives or hypertensives. FBS, serum creatinine, urinary albumin and creatinine were estimated. Urinary ACR and eGFR and were calculated. The data result was expressed as mean and standard deviation. A probability value is less than 0.05 and it was considered statistically significant.Conclusions: Type 2 diabetes mellitus patients, HbA1c and duration of diabetes were the strongest predictors of micro albuminuria and age was the strongest predictors of a low eGFR. The diabetes was poorly controlled, making the progression to end stage renal failure in concern patients. They measure the prevention of urinary albumin excretion, development of renal abrasion, smoking termination, strict glycaemic control and initiating lipid lowering therapy.

Abstract P199: Effectiveness Of Intensive Lipid-lowering Therapy With Statins In Type 2 Diabetes Mellitus Patients With Poorly Controlled Blood Pressure

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Shota Ikeda ◽  
Keisuke Shinohara ◽  
Nobuyuki Enzan ◽  
Shouji Matsushima ◽  
Takeshi Tohyama ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Standard Therapy ◽  
Intensive Therapy ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy

Introduction: Control of blood pressure (BP) is associated with decreased risk of cardiovascular (CV) events in patients with type 2 diabetes mellitus (T2DM). Lowering the level of low-density lipoprotein cholesterol (LDL-C) by statins is also effective to reduce CV events in T2DM patients with hyperlipidemia. In this study, we examined whether the effectiveness of statin lipid-lowering therapy was affected by baseline BP level in T2DM patients in a primary prevention setting. Methods: The EMPATHY study was a randomized controlled trial investigating the effects of statin intensive therapy targeting LDL-C <70 mg/dL compared to standard therapy targeting LDL-C ≥100 to <120 mg/dL in T2DM patients with diabetic retinopathy and hyperlipidemia without known CV diseases. In this post-hoc subgroup analysis, a total of 4980 patients were divided into two groups based on baseline BP: high BP (systolic BP ≥130 mmHg and/or diastolic BP ≥80 mmHg) and non-high BP (systolic BP <130 mmHg and diastolic BP <80 mmHg) groups. CV events were defined as composite of cardiac, cerebral, renal, and vascular events. Results: At baseline, mean systolic and diastolic BP values were 141.7 and 78.3 mmHg in high BP group (n=3335) and 120.2 and 67.9 mmHg in non-high BP group (n=1645). Compared to non-high BP group, the proportion of patients with diabetic nephropathy (55.5 % vs 46.6 %), body mass index (26.1 kg/m 2 vs 24.8 kg/m 2 ), HbA1c (7.82 % vs 7.67 %), and LDL-C (131.3 mg/dL vs 129.6 mg/dL) were significantly higher in high BP group. During a median follow-up of 36.8 months, 281 CV events were observed. In high BP group, statin intensive therapy was associated with low risk of CV events (HR 0.70, 95% CI 0.54-0.92, p=0.011) compared to standard therapy after adjustment. In non-high BP group, no such association was observed. Interaction between BP group and statin therapy was significant in CV events (p=0.036). Conclusion: Compared to statin standard therapy, statin intensive therapy targeting LDL-C <70 mg/dL significantly reduced CV events in the primary prevention setting among T2DM patients with BP ≥130/80 mmHg, but not among those with BP <130/80 mmHg.

scholarly journals Dyslipidaemia pattern and prevalence among type 2 diabetes mellitus patients on lipid-lowering therapy at a tertiary hospital in central South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lebohang Pitso ◽  
Thabiso Rafaki Petrus Mofokeng ◽  
Riette Nel
Keyword(s):  
Diabetes Mellitus ◽  
South Africa ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy ◽  
Central South

Abstract Background Atherosclerotic cardiovascular disease (ASCVD) is a major cause of death worldwide. A large number of deaths due to ASCVD occurs among people with diabetes mellitus (DM). One of the important modifiable risk factors associated with ASCVD is dyslipidaemia and its prevalence is not known in central South Africa (SA). This study aimed to determine the pattern and prevalence of dyslipidaemia among type 2 diabetes mellitus (T2DM) patients on lipid-lowering therapy. Methods This descriptive, retrospective study of patients’ records was conducted at Universitas Academic Hospital in Bloemfontein, SA. The study population included 143 consecutive T2DM patients of any age that attended the Diabetes Clinic from 1 January to 31 March 2019. The patients had to be on lipid-lowering therapy for a minimum duration of 3 months. Data were sourced from the clinic files and included the patient’s lipid profile, anthropometric and demographic data. Dyslipidaemia was defined using the 2018 SA dyslipidaemia guidelines. Results The median age of the participants was 63 years (interquartile range [IQR] 52–71 years). The majority of the participants were female (n = 92; 64.3 %). The median duration since the DM diagnosis was 18 years (IQR 13–23 years). The prevalence of dyslipidaemia was 86.7 % (n = 124). Combined dyslipidaemia, namely either triglycerides (TG) + low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL) + TG or HDL + LDL, was the most common pattern (n = 51; 42.5 %) largely due to raised TG + LDL contributing 37.2 % (n = 19) to this pattern. The second and third most common patterns were isolated (either LDL, HDL or TG) and mixed dyslipidaemia (TG + HDL + LDL) at 40.8 % (n = 49) and 16.7 % (n = 20), respectively. The most frequent lipid abnormality (n = 84; 70.0 %) was LDL of ≥ 1.8 mmol/L. Of the 140 participants on statin therapy, only 5 % were on high-intensity therapy. Conclusions A high prevalence of dyslipidaemia among DM patients was observed, despite the use of lipid-lowering therapy in this small observational study. Our findings highlight the need to better educate healthcare providers regarding the intensification of lipid-lowering therapy, along with improved strategies to address poor glycaemic control and other modifiable lifestyle factors.

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