scholarly journals Cholesterol levels and development of cardiovascular disease in Koreans with type 2 diabetes mellitus and without pre-existing cardiovascular disease

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Mee Kyoung Kim ◽  
Kyungdo Han ◽  
Han Na Joung ◽  
Ki-Hyun Baek ◽  
Ki-Ho Song ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Cox Regression ◽  
Reference Group ◽  
Density Lipoprotein ◽  
Type 2 Dm ◽  
Increased Risk

Abstract Background The aim of the present study was to identify a threshold for the cholesterol level at which the risk of cardiovascular disease (CVD) begins to increase in people with type 2 diabetes mellitus (DM). Methods Using the Korean National Health Insurance Service database, 2,077,135 people aged ≥ 40 years with type 2 DM who underwent regular health checks between 2009 and 2012 were included. Subjects with previous CVD were excluded. Cox regression analyses were performed to estimate the risk of CVD for each low-density lipoprotein cholesterol (LDL-C) group using the < 70 mg/dL as the reference group. Results There were 78,560 cases of stroke (3.91%), and 50,791 myocardial infarction (MI, 2.53%) during a median follow-up of 7.1 years. Among participants not taking statins, LDL-C levels of 130–159 mg/dL and ≥ 160 mg/dL were significantly associated with the risk of MI: the hazard ratios (HRs) (95% confidence interval) were 1.19 (1.14–1.25) and 1.53 (1.46–1.62), respectively. Among participants taking statins, all categories of LDL-C level ≥ 70 mg/dL were significantly associated with increased risk of stroke and MI. Conclusions We identified an increased risk of CVD in people with an LDL-C level ≥ 130 mg/dL among individuals with type 2 DM not taking statins. The risk of CVD was significantly higher in those taking statins with an LDL-C level ≥ 70 mg/dL.

Metformin Use Is Associated with a Lower Risk of Inflammatory Bowel Disease in Patients with Type 2 Diabetes Mellitus

2020 ◽  
Author(s):  
Chin-Hsiao Tseng
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Inflammatory Bowel Disease ◽  
Type 2 Diabetes Mellitus ◽  
Bowel Disease ◽  
Cox Regression ◽  
Reference Group ◽  
Hazard Ratios ◽  
Inflammatory Bowel

Abstract Aim Our aim was to compare the risk of developing inflammatory bowel disease [IBD] between ever users and never users of metformin. Methods Patients with newly diagnosed type 2 diabetes mellitus from 1999 to 2005 were enrolled from Taiwan’s National Health Insurance. A total of 340 211 ever users and 24 478 never users who were free from IBD on January 1, 2006 were followed up until December 31, 2011. Hazard ratios were estimated by Cox regression incorporating the inverse probability of treatment weighting using a propensity score. Results New-onset IBD was diagnosed in 6466 ever users and 750 never users. The respective incidence rates were 412.0 and 741.3 per 100 000 person-years and the hazard ratio for ever vs never users was 0.55 [95% confidence interval: 0.51–0.60]. A dose–response pattern was observed while comparing the tertiles of cumulative duration of metformin therapy to never users. The respective hazard ratios for the first [&lt;26.0 months], second [26.0–58.3 months] and third [&gt;58.3 months] tertiles were 1.00 [0.93–1.09], 0.57 [0.52–0.62] and 0.24 [0.22–0.26]. While patients treated with oral antidiabetic drugs [OADs] without metformin were treated as a reference group, the hazard ratios for patients treated with OADs with metformin, with insulin without metformin [with/without other OADs] and with insulin and metformin [with/without other OADs] were 0.52 [0.42–0.66], 0.95 [0.76–1.20] and 0.50 [0.40–0.62], respectively. Conclusion A reduced risk of IBD is consistently observed in patients with type 2 diabetes mellitus who have been treated with metformin.

Euglycemic Diabetic Ketoacidosis Associated With Sodium–Glucose Cotransporter Type 2 Inhibitors in Patients With Type 2 Diabetes Mellitus Receiving Oral Therapy

2017 ◽  
Vol 32 (2) ◽  
pp. 240-243 ◽  
Author(s):  
Ryan B. Dull ◽  
Mikayla L. Spangler ◽  
Emily L. Knezevich ◽  
Britney M. Lau
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Ketoacidosis ◽  
Case Reports ◽  
Serious Adverse Events ◽  
Type 2 Dm ◽  
Sodium Glucose Cotransporter ◽  
Increased Risk

Introduction and Objective: Postmarketing reports and warnings of serious adverse events such as diabetic ketoacidosis (DKA) have raised concern regarding the safety of sodium–glucose cotransporter 2 inhibitors (SGLT2i). This report describes 2 cases of symptomatic SGLT2i-associated euglycemic DKA (euDKA) leading to hospitalization in patients with type 2 diabetes mellitus (DM) previously well controlled on oral medications. Case Reports: Subject 1 is a 55-year-old female admitted with euDKA precipitated by infection and managed with intravenous insulin. This case was notable for a delayed diagnosis of euDKA and lack of clinical improvement despite withholding dapagliflozin. Subject 2 is a 62-year-old male admitted with euDKA precipitated by infection. His clinical condition improved rapidly and euDKA responded to withdrawal of empagliflozin alone. Discussion: Applying the Naranjo adverse medication reaction probability scale to each case (subject 1 score = 3 points; subject 2 score = 4 points) suggests these are possible adverse reactions to SGLT2i. Data from randomized controlled trials suggest DKA events in adults with type 2 DM receiving SGLT2i are rare and similar to placebo. However, data from a large cohort suggest these events occur more frequently and are associated with a 2-fold increased risk of DKA. Conclusion: This class of medications may be associated with a higher real-world risk of DKA in adults with type 2 DM than previously reported. Patients prescribed these medications should receive vigilant assessment for features of traditional DKA as well as euDKA.

scholarly journals Serum Total Homocysteine as a Potential Predictor for Increased Risk for Cardiovascular Disease Among Type 2 Diabetes Mellitus Patients

2015 ◽  
Vol 144 (suppl 2) ◽  
pp. A068-A068
Author(s):  
Ron Christian Sison ◽  
Avie Lynne Buenaventura ◽  
Kristofer Lanz Casquite ◽  
Cyruz Jan David ◽  
Christel Marie Jimenez ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Potential Predictor ◽  
Increased Risk ◽  
Total Homocysteine

scholarly journals Snoring frequency and risk of type 2 diabetes mellitus: a prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e042469
Author(s):  
Ningbin Dai ◽  
Qianwen Shi ◽  
Yujie Hua ◽  
Yu Guo ◽  
Zheng Bian ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cohort Study ◽  
Interaction Effect ◽  
Chinese Population ◽  
Cox Regression ◽  
Baseline Survey ◽  
Increased Risk

ObjectiveTo evaluate the association between snoring frequency and type 2 diabetes mellitus (T2DM) according to age and gender in Chinese population.DesignA cohort study was performed in Suzhou site of the China Kadoorie Biobank. Residents who didn’t suffer from T2DM at baseline survey (2004–2008) and in half a year after baseline were enrolled in this study and followed cause-specific morbidity until 31 December 2013. All participants were requested to complete a detailed questionnaire and undergo anthropometric measurements. Cox regression models were used to estimate HRs and 95% CIs for the snoring and T2DM association.SettingWuzhong district, Suzhou, China.ParticipantsA total of 49 453 participants (men: 41.8%; mean age: 51.14±10.28 years) were enrolled in this study.Outcome measuresT2DM cases were defined as International Classification of Diseases 10th Revision code of E11 and were identified through disease registries and health insurance databases.ResultsDuring a media of 7.18 years follow-up, 1120 T2DM cases were identified. Higher T2DM incidence was observed in participants with frequent and occasional snoring compared with those without (4.80 and 2.87 vs 2.39 per 1000 person-years). The multivariable-adjusted model found snoring was independently associated with T2DM (HR 1.28, 95% CI 1.20 to 1.38), both in men (HR 1.25, 95% CI 1.10 to 1.41) and women (HR 1.28, 95% CI 1.17 to 1.39). Moreover, a significant multiplicative interaction effect between snoring and age was detected on T2DM risk (p=0.015).ConclusionsSnoring was independently associated with an increased risk of T2DM in Chinese population, both in men and women. Meanwhile, there was an interaction effect between snoring and age on T2DM risk.

scholarly journals High Bodyweight Variability Increases Depression Risk in Patients With Type 2 Diabetes Mellitus: A Nationwide Cohort Study in Korea

2021 ◽  
Vol 12 ◽  
Author(s):  
Ji Hyun An ◽  
Kyung-do Han ◽  
Jin-Hyung Jung ◽  
Juhwan Yoo ◽  
Maurizio Fava ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Body Weight ◽  
Obese Patients ◽  
Type 2 Dm ◽  
Increased Risk ◽  
Quartile Group ◽  
New Onset

Objectives: Although obesity is associated with increased risk for depression in patients with type 2 diabetes mellitus (DM), the relationship between body weight variability (BWV) and depression remains poorly studied. This study was to investigate the incidence of depression in patients with type 2 DM according to their BWV.Methods: Intraindividual variation in body weight were measured in the nationwide, population-based retrospective cohort of 540,293 patients with type 2 DM from the Korean national health insurance system between 2009 and 2010. The diagnoses of new-onset depression occurring until the end of 2017 were ascertained. Risk of new-onset depression was examined using multivariate-adjusted Cox proportional hazards regression analysis by BWV quartile.Results: 93,149 (17.2%) patients developed new-onset depression for the follow up. BWV was significantly associated with an increased risk of depression after adjusting for confounding factors. The highest BWV quartile group had a hazard ratio (HR) of 1.17 (95% CI 1.15–1.19) compared to the lowest BWV quartile group as a reference. Obese patients in the highest BWV quartile group showed 12% increased risk of depression (HR 1.12, 95% CI 1.09–1.15) while non-obese patients in the highest BWV quartile group showed 20% increased risk of depression (HR: 1.20, 95% CI: 1.17–1.23) compared to their respective lowest BWV quartile groups.Conclusion: A higher BWV was significantly associated with an increased risk of depression in patients with type 2 DM. Thus, BWV may serve as an indicator for early detection of depression in type 2 DM patients.

scholarly journals Association between uric acid level and incidence of macroalbuminuria in people with type 2 diabetes mellitus: A 4.5-year cohort study

2019 ◽  
Author(s):  
Yun-Ju Lai ◽  
Yu-Yen Chen ◽  
Li-Jung Chen ◽  
Po-Wen Ku ◽  
Kuo-Chuan Hung ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Cox Regression ◽  
Characteristic Curve ◽  
Cox Regression Analysis ◽  
Increased Risk

Abstract Background: Using animal models and molecular biology researches, hyperuricemia has been shown to instruct renal arteriolopathy, arterial hypertension, and microvascular injury involving the renin-angiotensin system and resulting in renal function impairment. Nevertheless, the association between uric acid levels and the development of macroalbuminuria has been under-investigated in people with type 2 diabetes mellitus. Methods: Patients with type 2 diabetes and regular outpatient visits were recruited from a community hospital in Taiwan since January 2014. Demographics, lifestyle features, and medical history were gathered by well-trained interviewers. All participants underwent comprehensive physical examinations, including a biochemical assay of venous blood specimens and urine samples after an 8-hour overnight fast. Participants were followed until June 2018. The primary outcome was the macroalbuminuria incidence. Univariable and multivariable Cox regression analysis were employed to explore the relation between uric acid and incident macroalbuminuria. Uric acid cutoffs for incident macroalbuminuria were determined with the receiver operator characteristic curve. Results: We included 247 qualified subjects (mean age: 64.78 years old [standard deviation=11.29 years]; 138 [55.87%] men). During a 4.5-year follow-up duration, 20 subjects with incident macroalbuminuria were recognized. Serum uric acid was significantly associated with an increased risk of incident macroalbuminuria (adjusted hazard ratio=2.39; 95% confidence interval: 1.53-3.75; p<0.001) with potential confounders adjustment. The uric acid cutoff point was 6.9 mg/dL (area under the curve 0.708, sensitivity 60.0%, specificity 84.58%) for incident macroalbuminuria. Conclusions: Serum uric acid was associated with incident macroalbuminuria among people with type 2 diabetes.

scholarly journals Underweight is a major risk factor for atrial fibrillation in Asian people with type 2 diabetes mellitus

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Jung-Chi Hsu ◽  
Yen-Yun Yang ◽  
Shu-Lin Chuang ◽  
Yi-Wei Chung ◽  
Chih-Hsien Wang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Atrial Fibrillation ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cox Regression ◽  
Reference Group ◽  
University Hospital ◽  
Rank Test ◽  
Obesity Class

Abstract Background Atrial fibrillation (AF) is prevalent in patients with type 2 diabetes mellitus (T2DM). Obesity commonly accompanies T2DM, and increases the risk of AF. However, the dose-relationship between body mass index (BMI) and AF risk has seldom been studied in patients with diabetes. Methods This cohort study utilized a database from National Taiwan University Hospital, a tertiary medical center in Taiwan. Between 2014 and 2019, 64,339 adult patients with T2DM were enrolled for analysis. BMI was measured and categorized as underweight (BMI < 18.5), normal (18.5 ≤ BMI < 24), overweight (24 ≤ BMI < 27), obesity class 1 (27 ≤ BMI < 30), obesity class 2 (30 ≤ BMI < 35), or obesity class 3 (BMI ≥ 35). Multivariate Cox regression and spline regression models were employed to estimate the relationship between BMI and the risk of AF in patients with T2DM. Results The incidence of AF was 1.97 per 1000 person-years (median follow-up, 70.7 months). In multivariate Cox regression, using normal BMI as the reference group, underweight (HR 1.52, 95% CI 1.25–1.87, p < 0.001) was associated with a significantly higher risk of AF, while overweight was associated with significantly reduced risk of AF (HR 0.82, 95% CI 0.73–0.89, p < 0.001). Kaplan–Meier analysis showed AF risk was highest in the underweight group, followed by obesity class 3, while the overweight group had the lowest incidence of AF (log-rank test, p < 0.001). The cubic restrictive spline model revealed a “J-shaped” or “L-shaped” relationship between BMI and AF risk. Conclusions Underweight status confers the highest AF risk in Asian patients with T2DM.

scholarly journals Noncommunicable disease among adults with cerebral palsy

Neurology ◽  
2019 ◽  
Vol 93 (14) ◽  
pp. e1385-e1396 ◽  
Author(s):  
Jennifer M. Ryan ◽  
Mark D. Peterson ◽  
Anthony Matthews ◽  
Nicola Ryan ◽  
Kimberley J. Smith ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Cerebral Palsy ◽  
Respiratory Disease ◽  
Noncommunicable Disease ◽  
Increased Risk ◽  
Risk Of Cancer

ObjectiveTo compare the incidence of noncommunicable diseases between adults with and without cerebral palsy (CP).MethodsA cohort study was conducted using primary care data from the Clinical Practice Research Datalink. Cox models, stratified by matched set and adjusted for potential confounders, were fitted to compare the risk of any noncommunicable disease, cancer, cardiovascular disease, type 2 diabetes mellitus, and respiratory disease between adults with and without CP.ResultsThe analysis included 1,705 adults with CP and 5,115 age-, sex-, and general practice–matched adults without CP. There was evidence from adjusted analyses that adults with CP had 75% increased risk of developing any noncommunicable disease compared to adults without CP (hazard ratio [HR] 1.75, 95% confidence interval [CI] 1.58–1.94). Specifically, they had increased risk of cardiovascular disease (HR 1.76, 95% CI 1.48–2.11) and respiratory disease (HR 2.61, 95% CI 2.14–3.19). There was no evidence of increased risk of cancer or type 2 diabetes mellitus.ConclusionsAdults with CP had increased risk of noncommunicable disease, specifically cardiovascular and respiratory disease. These findings highlight the need for clinical vigilance regarding identification of noncommunicable disease in people with CP and further research into the etiology and management of noncommunicable disease in this population.

scholarly journals HIGH BLOOD GLUCOSE LEVEL INCREASE CARDIOVASCULAR DISEASE RISK IN TYPE 2 DIABETES MELLITUS

2017 ◽  
Vol 52 (2) ◽  
pp. 127
Author(s):  
Laili Zahrina Marchelia ◽  
Purwati Purwati ◽  
Rio Wironegoro
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Type 2 Diabetes Mellitus ◽  
Glucose Level ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Postprandial Glucose ◽  
Type 2 Dm

Type 2 diabetes mellitus (DM) is the 10th leading cause of death in the world and had a risk 4.06 times greater to have cardiovascular disease (CVD). Fasting plasma glucose and 2-hours postprandial glucose level as diagnostic tests to evaluate DM and also as a predictive factors to CVD. This research uses descriptive analytic research with cross sectional design. The subject of this study is Type 2 DM patients came to Dr Soetomo hospital from January-October 2014. Data was recorded from medical records of patients and was analyzed with Chi Square test with p<0.05. As result, there is 102 Type 2 DM patients with 36 patients have CVD manifestation and 66 patients without complication. There is a significant association between fasting plasma glucose (FPG), 2-hours postprandial glucose (2hPPG) level, and CVD manifestation (p=0.00). So FPG and 2hPPG have a significant association with CVD manifestation. There are other factors that influencing the formation of CVD, hence, further research is needed.

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