scholarly journals Waist circumference is associated with major adverse cardiovascular events in male but not female patients with type-2 diabetes mellitus

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhenhua Xing ◽  
Zhenyu Peng ◽  
Xiaopu Wang ◽  
Zhaowei Zhu ◽  
Junyu Pei ◽  
...  
Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Joseph Azuri ◽  
Enis Aboalhasan ◽  
Ariel Hammerman ◽  
Ronen Arbel

Introduction: The Glucagon-Like Peptide-1 receptor agonists (GLP-1a) semaglutide, dulaglutide, and liraglutide reduce major adverse cardiovascular events (MACE) in patients with Type 2 diabetes mellitus ( T2DM) and established CVD. The American Diabetes Association currently recommends providing GLP-1a therapy to this patient population independently of glycaemic control. Despite proven clinical benefits, providing GLP-1a to all guideline eligible patients is a significant cost burden on healthcare systems. Therefore, it is imperative to compare the value for money of these agents. Hypothesis: The newly introduced GLP-1a Semaglutide may be cost-saving compared to dulaglutide and liraglutide for preventing MACE in patients with established CVD and T2DM. Methods: We calculated the cost needed to prevent one MACE, by multiplying the annualized number needed to treat to prevent one event, by the annual cost of the therapy. Efficacy estimates were extracted from published RCT data. We performed a sensitivity analysis to mitigate differences between trial populations and other uncertainties. Drug costs were based on published US prices. Results: The cost needed to prevent one MACE with semaglutide is $557,187 ($331,491-$2,194,483) compared to $1,179,360 ($732,888-$2,746,224) with liraglutide and $1,605,904 ($706,044-∞) for dulaglutide. Sensitivity analysis confirmed the advantage of semaglutide. Conclusions: Semaglutide prescribed for secondary prevention of MACE in patients with T2DM and established CVD seems to provide more value for money than dulaglutide and liraglutide for the same purpose.


PLoS ONE ◽  
2020 ◽  
Vol 15 (5) ◽  
pp. e0233737
Author(s):  
Sona Margaryan ◽  
Eva Kriegova ◽  
Regina Fillerova ◽  
Veronika Smotkova Kraiczova ◽  
Gayane Manukyan

Author(s):  
Najla Shamsi

Type 2 Diabetes Mellitus is a prevalent chronic disease with several macrovascular and microvascular complications. Cardiovascular diseases including coronary artery disease and stroke are common macrovascular complication that reduces the quality of life and lead to early mortality. Additionally, they pose enormous socioeconomic burden on the societies and the governments. Therefore, any intervention that reduces the cardiovascular events in patients with diabetes will have positive impact of the patients and the society. Thus, this systematic review aimed to evaluate the cardiovascular events after metabolic surgery in comparison with the new classes of glucose lowering agents in patients with type 2 diabetes mellitus. The review included 11 randomized controlled trials to both GLP-1 RA and SGLT-2 i groups. It also included 7 metabolic surgery studies, 2 of these are randomized controlled trials and the other 5 are observational studies. These studies were the most relevant studies to the research question. The results revealed different baseline demographic and clinical characteristics between the medication trials and metabolic surgery studies. Moreover, it revealed significant reduction in cardiovascular events in metabolic surgery studies when compared to medication trials. It also showed significant HbA1c and weight reduction in the metabolic surgery group. The remission of diabetes was very high in the metabolic surgery group while none of medication trials accomplished diabetes recovery. However, both medication and surgery groups had adverse events. In conclusion, the review is consistent with previous literature. It suggests that metabolic surgery is more effective than medical therapy in reducing cardiovascular events. Although this conclusion should be interpreted with caution due to the differences in baseline characteristics between studies. In general, the review recommends younger adult diabetic patients with obesity and history of established cardiovascular diseases to undergo metabolic surgery. Whereas, older patients with history of cardiovascular disease should be advised to take one of the medications that has been proved to reduce cardiovascular events. Future studies that compare metabolic surgery and the new classes of the glucose lowering agents is recommended to confirm the findings in this review.


2020 ◽  
Vol 2 (2) ◽  
pp. 94
Author(s):  
Hafizha Firdaus Al-Fuady ◽  
Bambang Purwanto ◽  
Soebagijo Adi Soelistijo

AbstrakLatar Belakang: Diabetes melitus tipe 2 menjadi penyebab kematian nomer 3 di Indonesia. Kelebihan berat badan atau lingkar pinggang diatas normal dan kadar HDL-c rendah merupakan faktor risiko diabetes melitus tipe 2. Faktor risiko tersebut dapat diatasi salah satunya dengan olahraga. Senam PERSADIA 1 dirancang khusus untuk pencegahan diabetes. Namun, efek dari senam ini dalam menurunkan lingkar pinggang dan meningkatkan rasio HDL-c LDL-c belum pernah diteliti.Metode: Desain penelitian ini adalah eksperimen lapangan. Pengaruh Senam PERSADIA 1 terhadap lingkar pinggang dan rasio HDL-c LDL-c dianalisis dengan uji statistik deskriptif, uji normalitas saphiro wilk-test, uji beda berpasangan paired t-test / Wilcoxon-test.Hasil: Penelitian ini melibatkan 12 ibu-ibu PKK Lidah Wetan Gang V RW 2 Surabaya. Dari hasil analisis, terdapat penurunan rerata lingkar pinggang dan bermakna namun sedikit (p= 0,032), tidak ada peningkatan kadar HDL-c yang bermakna (p= 0,301), terdapat penurunan rerata LDL-c namun belum bermakna (p= 0,755), terdapat peningkatan rerata rasio HDL-c LDL-c namun belum bermakna (p= 0,303).Kesimpulan: Senam PERSADIA 1 dapat menurunkan lingkar pinggang namun sedikit dan belum dapat meningkatkan rasio HDL-c/LDL-c pada wanita secara bermakna menurut statistika. Diperlukan penelitian lebih lanjut dengan menambah waktu pelaksaan senam dan mengontrol energy intake subjek penelitian. Kata Kunci:. Diabetes melitus, Senam PERSADIA 1, lingkar pinggang, rasio HDL-c LDL-c, wanita AbstractBackground: Type 2 diabetes mellitus is the third causes of death in Indonesia. Overweight or waist circumference above normal and low HDL-c levels are risk factors for type 2 diabetes mellitus. One of the risk factors can be resolve with exercise. First series PERSADIA exercise is specifically designed for the prevention of diabetes. Howefer, the effect of this exercise in reducing waist circumference and increase ratio HDL-c LDL-c had never been proven.Method: The design of this study was a field experiment. The effect of first series PERSADIA exercise on waist circumference and HDL-c LDL-c ratio was analyzed by descriptive statistical test, saphiro wilk-test for normality test, paired t-test / Wilcoxon-test for different paired test.Result: This study involved 12 Women lived in Lidah Wetan Gang V RW 2 Surabaya. From the analysis, there was a decrease in mean waist circumference and significant but slightly (p = 0.032), there was no significant increase in HDL-c levels (p = 0.301), there was a decrease in LDL-c mean but it was not significant (p = 0.755), there was an increase in the mean HDL-c LDL-c ratio but it was not significant (p = 0.303).Conclusion: First series PERSADIA exercise has been able to reduce waist circumference but slightly and not able to increase HDL-c / LDL-c ratio significantly in women according to statistics. Further research is needed by increasing the exercise time and controlling the energy intake of subjects. Keywords: diabetes mellitus, first series PERSADIA exercise, waist circumference, HDL-c LDL-c ratio, women 


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