scholarly journals Retrospective cohort study of androgen deprivation therapy and the risk of diabetes in men with prostate cancer in Lithuania

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e045797
Author(s):  
Mingaile Drevinskaite ◽  
Ausvydas Patasius ◽  
Marius Kincius ◽  
Vincas Urbonas ◽  
Giedre Smailyte
Keyword(s):  
Prostate Cancer ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Androgen Deprivation Therapy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Androgen Deprivation ◽  
Gnrh Agonists ◽  
Increased Risk

ObjectivesTo examine the risk of type 2 diabetes in patients with prostate cancer and its association with androgen deprivation therapy (ADT).Design and participantsWe performed a retrospective cohort study of patients diagnosed with prostate cancer in the Lithuanian male population between 1 January 2003 and 31 December 2012 who were identified through the Lithuanian Cancer registry. All prostate cancer cases were linked to the National Health Insurance Fund database to obtain information regarding the diagnosis of diabetes mellitus and information on prescriptions of antiandrogens and gonadotropin-releasing hormone (GnRH) agonists. Patients with prostate cancer were followed up until the diagnosis of type 2 diabetes, or 31 December 2017, or date of death, whichever came first. Cox proportional hazard models were used to estimate the risk of type 2 diabetes in patients with prostate cancer with or without ADT exposure.Results27 580 men were diagnosed with prostate cancer, out of whom 14 502 (52.6%) did not receive ADT and 13 078 (47.4%) were treated with ADT. The incidence of type 2 diabetes for all patients with prostate cancer was 7.4/1000 person-years, for men on GnRH agonists 9.0/1000 person-years and 5.8/1000 person-years for men on antiandrogens. There was an increased risk of developing type 2 diabetes comparing ADT users and non-users (HR=1.49, 95% CI 1.34 to 1.66).ConclusionThis study showed an increased risk of diabetes in patients with prostate cancer treated with ADT in comparison to ADT-free patient cohort. GnRH agonist users showed higher susceptibility, while the group on antiandrogen monotherapy showed no such increase.

scholarly journals Increased Risk Of Type 2 Diabetes And Abnormal FPG Due To Shift Work Differs According To Gender: A Retrospective Cohort Study Among Thai Workers In Bangkok, Thailand

2019 ◽  
Vol Volume 12 ◽  
pp. 2341-2354
Author(s):  
Nitt Hanprathet ◽  
Somrat Lertmaharit ◽  
Vitool Lohsoonthorn ◽  
Thanapoom Rattananupong ◽  
Palanee Ammaranond ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Shift Work ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Increased Risk

scholarly journals Association between ischaemic bowel syndromes and androgen deprivation therapy in patients with prostate cancer: a retrospective cohort study

BMJ Open ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. e012950
Author(s):  
I-Ni Chiang ◽  
Chao-Yuan Huang ◽  
Yeong-Shiau Pu ◽  
Chao-Hsiang Chang ◽  
Chih-Hsin Muo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cohort Study ◽  
Androgen Deprivation Therapy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Androgen Deprivation

scholarly journals Renal Complication and Glycemic Control in Korean Veterans with Type 2 Diabetes: A 10-Year Retrospective Cohort Study

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Ye An Kim ◽  
Young Lee ◽  
Je Hyun Seo
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Glycemic Control ◽  
Elderly Patients ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Diabetes Complications ◽  
Hazard Ratios ◽  
Increased Risk

Objective. Tight glycemic control reduces the risk of diabetes complications, but it may increase the risk of hypoglycemia or mortality in elderly patients. This study is aimed at evaluating the incidence and progression of renal complications and its association with glycemic control in elderly patients with type 2 diabetes. Methods. This retrospective cohort study examined the data of 3099 patients with type 2 diabetes who were followed for at least 10 years at the Korean Veterans Hospital and for whom glycated hemoglobin (HbA1c) was measured in 2008 and 2017. Participants were divided into six groups according to their baseline or dynamic HbA1c levels. Extended Cox models were used to calculate adjusted hazard ratios for the development of chronic kidney disease (CKD) and end-stage renal disease (ESRD) associated with specific HbA1c ranges. Results. During the 10-year follow-up period, 30% of patients developed new CKD, 50% showed progression, and ESRD developed in 1.7%. The risk of CKD was associated with baseline HbA1c from the first year of the study and dynamic HbA1c throughout the study period. The adjusted hazard ratios for CKD were 1.98 and 2.32 for baseline and dynamic HbA1c, respectively, at the level of ≥69 mmol/mol. There was no increased risk for any complications in baseline and dynamic HbA1c below 58 mmol/mol. Conclusions. A higher HbA1c≥58 mmol/mol was associated with an increased risk of diabetes complications. A less stringent glycemic target of HbA1c could be used as the threshold of renal complications.

scholarly journals Is therapeutic inertia present in hyperglycaemia, hypertension and hypercholesterolaemia management among adults with type 2 diabetes in three health clinics in Malaysia? a retrospective cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Boon-How Chew ◽  
Husni Hussain ◽  
Ziti Akthar Supian
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Ldl Cholesterol ◽  
Therapeutic Inertia ◽  
Treatment Targets ◽  
Health Clinics

Abstract Background Good-quality evidence has shown that early glycaemic, blood pressure and LDL-cholesterol control in people with type 2 diabetes (T2D) leads to better outcomes. In spite of that, diseases control have been inadequate globally, and therapeutic inertia could be one of the main cause. Evidence on therapeutic inertia has been lacking at primary care setting. This retrospective cohort study aimed to determine the proportions of therapeutic inertia when treatment targets of HbA1c, blood pressure and LDL-cholesterol were not achieved in adults with T2D at three public health clinics in Malaysia. Methods The index prescriptions were those that when the annual blood tests were reviewed. Prescriptions of medication were verified, compared to the preceding prescriptions and classified as 1) no change, 2) stepping up and 3) stepping down. The treatment targets were HbA1c < 7.0% (53 mmol/mol), blood pressure (BP) < 140/90 mmHg and LDL-cholesterol < 2.6 mmol/L. Therapeutic inertia was defined as no change in the medication use in the present of not reaching the treatment targets. Descriptive, univariable, multivariable logistic regression and sensitive analyses were conducted. Results A total of 552 cohorts were available for the assessment of therapeutic inertia (78.9% completion rate). The mean (SD) age and diabetes duration were 60.0 (9.9) years and 5.0 (6.0) years, respectively. High therapeutic inertia were observed in oral anti-diabetic (61–72%), anti-hypertensive (34–65%) and lipid-lowering therapies (56–77%), and lesser in insulin (34–52%). Insulin therapeutic inertia was more likely among those with shorter diabetes duration (adjusted OR 0.9, 95% CI 0.87, 0.98). Those who did not achieve treatment targets were less likely to experience therapeutic inertia: HbA1c ≥ 7.0%: adjusted OR 0.10 (0.04, 0.24); BP ≥ 140/90 mmHg: 0.28 (0.16, 0.50); LDL-cholesterol ≥ 2.6 mmol/L: 0.37 (0.22, 0.64). Conclusions Although therapeutic intensifications were more likely in the presence of non-achieved treatment targets but the proportions of therapeutic inertia were high. Possible causes of therapeutic inertia were less of the physician behaviours but might be more of patient-related non-adherence or non-availability of the oral medications. These observations require urgent identification and rectification to improve disease control, avoiding detrimental health implications and costly consequences. Trial registration Number NCT02730754, April 6, 2016.

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