Performance of the recommended ESC/EASD cardiovascular risk stratification model in comparison to SCORE and NT-proBNP as a single biomarker for risk prediction in type 2 diabetes mellitus

Abstract Background Recently, the European Society of Cardiology (ESC) and European Association for the Society of Diabetes (EASD) introduced a new cardiovascular disease (CVD) risk stratification model to aid further treatment decisions in individuals with diabetes. Our study aimed to investigate the prognostic performance of the ESC/EASD risk model in comparison to the Systematic COronary Risk Evaluation (SCORE) risk model and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in an unselected cohort of type 2 diabetes mellitus (T2DM). Methods and results A total of 1690 T2DM patients with a 10-year follow up for fatal CVD and all-cause death and a 5-year follow up for CVD and all-cause hospitalizations were analyzed. According to ESC/EASD risk criteria 25 (1.5%) patients were classified as moderate, 252 (14.9%) high, 1125 (66.6%) very high risk and 288 (17.0%) were not classifiable. Both NT-proBNP and SCORE risk model were associated with 10-year CVD and all-cause death and 5-year CVD and all-cause hospitalizations while the ESC/EASD model was only associated with 10-year all-cause death and 5-year all-cause hospitalizations. NT-proBNP and SCORE showed significantly higher C-indices than the ESC/EASD risk model for CVD death [0.80 vs. 0.53, p < 0.001; 0.64 vs. 0.53, p = 0.001] and all-cause death [0.73, 0.66 vs. 0.52, p < 0.001 for both]. The performance of SCORE improved in a subgroup without CVD aged 40–64 years compared to the unselected cohort, while NT-proBNP performance was robust across all groups. Conclusion The new introduced ESC/EASD risk stratification model performed limited compared to SCORE and single NT-proBNP assessment for predicting 10-year CVD and all-cause fatal events in individuals with T2DM.

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Performance of NT-proBNP as a single biomarker in comparison to SCORE and the recommended ESC/EASD cardiovascular risk stratification model for risk prediction in type 2 diabetes mellitus

10.21203/rs.3.rs-58028/v1 ◽

2020 ◽

Author(s):

Suriya Prausmüller ◽

Michael Resl ◽

Henrike Arfsten ◽

Georg Spinka ◽

Raphael Wurm ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Risk Stratification ◽

Risk Model ◽

Risk Stratification Model ◽

Score Risk ◽

Unselected Cohort

Abstract Background. Recently, the European Society of Cardiology (ESC) and European Association for the Society of Diabetes (EASD) introduced a new cardiovascular (CV) risk stratification model to aid further treatment decisions in individuals with diabetes. Our study aimed to investigate the prognostic performance of NT-proBNP and the Systematic COronary Risk Evaluation (SCORE) compared to the ESC/EASD risk model in an unselected cohort of type 2 diabetes mellitus (T2DM).Methods & Results. A total of 1690 T2DM patients with a 10-year follow up for fatal CV and all-cause death and a 5-year follow up for CV and all-cause hospitalizations were analyzed. According to ESC/EASD risk criteria 25 (1.5%) patients were classified as moderate, 252 (14.9%) high, 1125 (66.6%) very high risk and 288 (17.0%) were not classifiable. NT-proBNP, the ESC/EASD and SCORE risk model were all associated with 10-year CV and all-cause death and 5-year CV and all-cause hospitalizations. NT-proBNP showed significantly higher C-indices than the ESC/EASD and SCORE risk model for CV death [0.80 vs 0.53 vs 0.64, p<0.001] and all-cause death [0.73 vs 0.52 vs 0.66, p<0.001]. The performance of SCORE improved in a subgroup without CV disease aged 40-64 years compared to the unselected cohort, whilst performance of NT-proBNP was robust across all groups. Conclusion. NT-proBNP is a high-performing biomarker for CV risk assessment in T2DM. Single NT-proBNP is superior compared to SCORE and the multiparameter ESC/EASD risk stratification model for predicting 10-year CV and all-cause fatal events.

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Performance of the recommended ESC/EASD cardiovascular risk stratification model in comparison to SCORE and NT-proBNP as a single biomarker for risk prediction in type 2 diabetes mellitus

10.21203/rs.3.rs-58028/v3 ◽

2021 ◽

Author(s):

Suriya Prausmüller ◽

Michael Resl ◽

Henrike Arfsten ◽

Georg Spinka ◽

Raphael Wurm ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Risk Stratification ◽

Risk Model ◽

Risk Stratification Model ◽

Score Risk ◽

Unselected Cohort

Abstract Background. Recently, the European Society of Cardiology (ESC) and European Association for the Society of Diabetes (EASD) introduced a new cardiovascular disease (CVD) risk stratification model to aid further treatment decisions in individuals with diabetes. Our study aimed to investigate the prognostic performance of the ESC/EASD risk model in comparison to the Systematic COronary Risk Evaluation (SCORE) risk model and NT-proBNP in an unselected cohort of type 2 diabetes mellitus (T2DM).Methods & Results. A total of 1690 T2DM patients with a 10-year follow up for fatal CVD and all-cause death and a 5-year follow up for CVD and all-cause hospitalizations were analyzed. According to ESC/EASD risk criteria 25 (1.5%) patients were classified as moderate, 252 (14.9%) high, 1125 (66.6%) very high risk and 288 (17.0%) were not classifiable. Both, NT-proBNP and SCORE risk model were associated with 10-year CVD and all-cause death and 5-year CVD and all-cause hospitalizations while the ESC/EASD model was only associated with 10-year all-cause death and 5-year all-cause hospitalizations. NT-proBNP and SCORE showed significantly higher C-indices than the ESC/EASD risk model for CVD death [0.80 vs 0.53, p<0.001; 0.64 vs 0.53, p=0.001] and all-cause death [0.73, 0.66 vs 0.52, p<0.001 for both].The performance of SCORE improved in a subgroup without CVD aged 40-64 years compared to the unselected cohort, while NT-proBNP performance was robust across all groups.Conclusion. The new introduced ESC/EASD risk stratification model performed limited compared to SCORE and single NT-proBNP assessment for predicting 10-year CVD and all-cause fatal events in individuals with T2DM.

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Performance of the recommended ESC/EASD cardiovascular risk stratification model and SCORE in comparison to NT-proBNP as a single biomarker for risk prediction in type 2 diabetes mellitus

10.21203/rs.3.rs-58028/v2 ◽

2020 ◽

Author(s):

Suriya Prausmüller ◽

Michael Resl ◽

Henrike Arfsten ◽

Georg Spinka ◽

Raphael Wurm ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Risk Stratification ◽

Risk Model ◽

Risk Stratification Model ◽

Score Risk ◽

Unselected Cohort

Abstract Background. Recently, the European Society of Cardiology (ESC) and European Association for the Society of Diabetes (EASD) introduced a new cardiovascular disease (CVD) risk stratification model to aid further treatment decisions in individuals with diabetes. Our study aimed to investigate the prognostic performance of the ESC/EASD risk model and the Systematic COronary Risk Evaluation (SCORE) in comparison to NT-proBNP in an unselected cohort of type 2 diabetes mellitus (T2DM).Methods & Results. A total of 1690 T2DM patients with a 10-year follow up for fatal CVD and all-cause death and a 5-year follow up for CVD and all-cause hospitalizations were analyzed. According to ESC/EASD risk criteria 25 (1.5%) patients were classified as moderate, 252 (14.9%) high, 1125 (66.6%) very high risk and 288 (17.0%) were not classifiable. Both, NT-proBNP and SCORE risk model were associated with 10-year CVD and all-cause death and 5-year CVD and all-cause hospitalizations while the ESC/EASD model was only associated with 10-year all-cause death and 5-year all-cause hospitalizations. NT-proBNP showed significantly higher C-indices than the ESC/EASD and SCORE risk model for CVD death [0.80 vs 0.53 vs 0.64, p<0.001] and all-cause death [0.73 vs 0.52 vs 0.66, p<0.001]. The performance of SCORE improved in a subgroup without CVD aged 40-64 years compared to the unselected cohort, while NT-proBNP performance was robust across all groups.Conclusion. The new introduced ESC/EASD risk stratification model performed limited compared to SCORE and single NT-proBNP assessment for predicting 10-year CVD and all-cause fatal events in individuals with T2DM.

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Development of a predictive risk model for all-cause mortality in patients with diabetes in Hong Kong

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001950 ◽

2021 ◽

Vol 9 (1) ◽

pp. e001950

Author(s):

Sharen Lee ◽

Jiandong Zhou ◽

Keith Sai Kit Leung ◽

William Ka Kei Wu ◽

Wing Tak Wong ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Deep Learning ◽

Risk Model ◽

All Cause Mortality ◽

Patients With Diabetes ◽

Predictive Risk

IntroductionPatients with diabetes mellitus are risk of premature death. In this study, we developed a machine learning-driven predictive risk model for all-cause mortality among patients with type 2 diabetes mellitus using multiparametric approach with data from different domains.Research design and methodsThis study used territory-wide data of patients with type 2 diabetes attending public hospitals or their associated ambulatory/outpatient facilities in Hong Kong between January 1, 2009 and December 31, 2009. The primary outcome is all-cause mortality. The association of risk variables and all-cause mortality was assessed using Cox proportional hazards models. Machine and deep learning approaches were used to improve overall survival prediction and were evaluated with fivefold cross validation method.ResultsA total of 273 678 patients (mean age: 65.4±12.7 years, male: 48.2%, median follow-up: 142 (IQR=106–142) months) were included, with 91 155 deaths occurring on follow-up (33.3%; annualized mortality rate: 3.4%/year; 2.7 million patient-years). Multivariate Cox regression found the following significant predictors of all-cause mortality: age, male gender, baseline comorbidities, anemia, mean values of neutrophil-to-lymphocyte ratio, high-density lipoprotein-cholesterol, total cholesterol, triglyceride, HbA1c and fasting blood glucose (FBG), measures of variability of both HbA1c and FBG. The above parameters were incorporated into a score-based predictive risk model that had a c-statistic of 0.73 (95% CI 0.66 to 0.77), which was improved to 0.86 (0.81 to 0.90) and 0.87 (0.84 to 0.91) using random survival forests and deep survival learning models, respectively.ConclusionsA multiparametric model incorporating variables from different domains predicted all-cause mortality accurately in type 2 diabetes mellitus. The predictive and modeling capabilities of machine/deep learning survival analysis achieved more accurate predictions.

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Vitamin D Supplementation and Serum Levels of Magne-sium and Selenium in Type 2 Diabetes Mellitus Patients: Gender Dimorphic Changes

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000190 ◽

2014 ◽

Vol 84 (1-2) ◽

pp. 27-34 ◽

Cited By ~ 7

Author(s):

Nasser M. Al-Daghri ◽

Khalid M. Alkharfy ◽

Nasiruddin Khan ◽

Hanan A. Alfawaz ◽

Abdulrahman S. Al-Ajlan ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Vitamin D ◽

Type 2 Diabetes Mellitus ◽

Serum Levels ◽

Vitamin D Supplementation ◽

Serum Selenium ◽

Dependent Manner

The aim of our study was to evaluate the effects of vitamin D supplementation on circulating levels of magnesium and selenium in patients with type 2 diabetes mellitus (T2DM). A total of 126 adult Saudi patients (55 men and 71 women, mean age 53.6 ± 10.7 years) with controlled T2DM were randomly recruited for the study. All subjects were given vitamin D3 tablets (2000 IU/day) for six months. Follow-up mean concentrations of serum 25-hydroxyvitamin D [25-(OH) vitamin D] significantly increased in both men (34.1 ± 12.4 to 57.8 ± 17.0 nmol/L) and women (35.7 ± 13.5 to 60.1 ± 18.5 nmol/L, p < 0.001), while levels of parathyroid hormone (PTH) decreased significantly in both men (1.6 ± 0.17 to 0.96 ± 0.10 pmol/L, p = 0.003) and women (1.6 ± 0.17 to 1.0 ± 0.14 pmol/L, p = 0.02). In addition, there was a significant increase in serum levels of selenium and magnesium in men and women (p-values < 0.001 and 0.04, respectively) after follow-up. In women, a significant correlation was observed between delta change (variables at six months-variable at baseline) of serum magnesium versus high-density lipoprotein (HDL)-cholesterol (r = 0.36, p = 0.006) and fasting glucose (r = - 0.33, p = 0.01). In men, there was a significant correlation between serum selenium and triglycerides (r = 0.32, p = 0.04). Vitamin D supplementation improves serum concentrations of magnesium and selenium in a gender-dependent manner, which in turn could affect several cardiometabolic parameters such as glucose and lipids.

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Telephone follow-up for type 2 diabetes mellitus

10.1002/14651858.cd006694.pub2 ◽

2012 ◽

Author(s):

Lihua Wu ◽

Angus Forbes ◽

Peter D Griffiths ◽

Alison While

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus

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Insulin Dose Adjustment Following Bariatric Surgery, a Review of Available Literature

Journal of Diabetes Science and Technology ◽

10.1177/19322968211028886 ◽

2021 ◽

pp. 193229682110288

Author(s):

Lynn E. Kassel ◽

Jessica J. Berei ◽

Jamie M. Pitlick ◽

Joel E. Rand

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Bariatric Surgery ◽

Type 2 Diabetes Mellitus ◽

Dose Adjustment ◽

Insulin Dose ◽

Appraisal Tool

Bariatric surgery is a known and effective treatment for type 2 diabetes mellitus. Patients with type 1 diabetes mellitus and exogenous insulin-requiring type 2 diabetes mellitus require adjusted insulin dosing after surgery to avoid hypoglycemia. This review describes insulin dose adjustments following a variety of bariatric procedures. After searching the available literature and assessing for eligibility, 8 articles were included. The Johns Hopkins Research Evidence Appraisal Tool for literature appraisal was used. The results of this review reveal insulin dose adjustment varies based upon surgical procedure type and time of follow-up from the procedure.

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