scholarly journals Association between glycemic control and risk of venous thromboembolism in diabetic patients: a nested case–control study

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah H. R. Charlier ◽  
Christian Meier ◽  
Susan S. Jick ◽  
Christoph R. Meier ◽  
Claudia Becker
Keyword(s):  
Venous Thromboembolism ◽  
Glycemic Control ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
Diabetic Patients ◽  
Control Analysis ◽  
Using Data ◽  
Nested Case Control ◽  
The Impact ◽  
Hba1c Levels

Abstract Background Previous studies suggested an elevated risk of venous thromboembolism (VTE) among patients with type 2 diabetes mellitus (T2DM), with a possible sex difference. The impact of glycemic control on the risk of VTE is unclear. Our objective was to analyze the association between glycemic control and the risk of unprovoked (idiopathic) VTE in men and women with T2DM. Methods We conducted a nested case–control analysis (1:4 matching) within a cohort of patients with incident T2DM between 1995 and 2019 using data from the CPRD GOLD. We excluded patients with known risk factors for VTE prior to onset of DM. Cases were T2DM patients with an unprovoked treated VTE. The exposure of interest was glycemic control measured as HbA1c levels. We conducted conditional logistic regression analyses adjusted for several confounders. Results We identified 2′653 VTE cases and 10′612 controls (53.1% females). We found no association between the HbA1c level and the risk of VTE in our analyses. However, when the most recent HbA1c value was recorded within 90 days before the index date, women with HbA1c levels > 7.0% had a 36–55% increased relative risk of VTE when compared to women with HbA1c > 6.5–7.0%. Conclusions Our study raises the possibility that female T2DM patients with HbA1c levels > 7% may have a slightly higher risk for unprovoked VTE compared to women with HbA1c levels > 6.5–7.0%. This increase may not be causal and may reflect differences in life style or other characteristics. We observed no effect of glycemic control on the risk of VTE in men.

scholarly journals Association between glycemic control and risk of venous thromboembolism in diabetic patients: A nested case-control study

2021 ◽  
Author(s):  
Sarah H R Charlier ◽  
Christian Meier ◽  
Susan S Jick ◽  
Christoph R Meier ◽  
Claudia Becker
Keyword(s):  
Venous Thromboembolism ◽  
Glycemic Control ◽  
Hba1c Level ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
Diabetic Patients ◽  
Control Analysis ◽  
Nested Case Control ◽  
The Impact ◽  
Hba1c Levels

Abstract Background:Previous studies suggested an elevated risk of venous thromboembolism (VTE) among patients with type 2 diabetes mellitus (T2DM), with a possible sex difference. The impact of glycemic control on the risk of VTE is unclear. Our objective was to analyze the association between glycemic control and the risk of unprovoked (idiopathic) VTE in men and women with T2DM.Methods:We conducted a nested case-control analysis (1:4 matching) within a cohort of patients with incident T2DM between 1995–2019 using data from the CPRD GOLD. We excluded patients with known risk factors for VTE prior to onset of DM. Cases were T2DM patients with an unprovoked treated VTE. The exposure of interest was glycemic control measured as HbA1c levels. We conducted conditional logistic regression analyses adjusted for several confounders.Results:We identified 3’896 VTE cases and 15’584 controls (56% females). We found no association between the HbA1c level and the risk of VTE in our main analysis. However, when the most recent HbA1c value was within 90 days before the index date, women with HbA1c levels > 7.0% had an 18–35% increased relative risk of VTE when compared to women with HbA1c > 6.5-7.0%.Conclusions:Our study raises the possibility that female T2DM patients with HbA1c levels > 7% may have a slightly higher risk for unprovoked VTE compared to women with HbA1c level > 6.5-7.0%. This increase may not be causal and may reflect differences in life style or other characteristics. We observed no effect of glycemic control on the risk of VTE in men.

scholarly journals Association between malignancies and Marfan syndrome: a population-based, nested case–control study in Taiwan

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017243 ◽  
Author(s):  
Chin-Wang Hsu ◽  
Jen-Chun Wang ◽  
Wen-I Liao ◽  
Wu-Chien Chien ◽  
Chi-Hsiang Chung ◽  
...  
Keyword(s):  
Marfan Syndrome ◽  
Transforming Growth Factor ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
Signalling Pathway ◽  
Claim Database ◽  
Control Analysis ◽  
Research Database ◽  
Increased Risk ◽  
Nested Case Control

ObjectiveMarfan syndrome (MFS) involves a deficiency of the structural extracellular matrix component fibrillin-1 and overactivation of the transforming growth factor-β (TGF-β) signalling pathway. The TGF-β signalling pathway also actively participates in malignant transformation. Although anecdotal case reports have suggested associations between MFS/MFS-like conditions and several haematological and solid malignancies, such associations have not been thoroughly evaluated in large-scale studies. We sought to use a nationwide healthcare insurance claim database to evaluate whether patients with MFS are at increased risk of malignancy.Patients and methodsWe conducted a nested case–control analysis using a database extracted from Taiwan’s National Health Insurance Research Database. All medical conditions for each case and control were categorised using the International Classification of Diseases, 9th Revision classifications. ORs and 95% CIs for associations between MFS and malignancies were estimated using conditional logistic regression and adjusted for comorbidities.ResultsOur analyses included 1 153 137 cancer cases and 1 153 137 propensity score-matched controls. Relative to other subjects, patients with MFS had a significantly higher risk of having a malignancy (adjusted OR 3.991) and hypertension (adjusted OR 1.964) and were significantly more likely to be men. Malignancies originating from the head and neck and the urinary tract were significantly more frequent among patients with MFS than among subjects without MFS.ConclusionPatients with MFS are at increased risk of developing various malignancies. Healthcare professionals should be aware of this risk when treating such patients, and increased cancer surveillance may be necessary for these patients.

Antidiabetic Treatment, Level of Glycemic Control, and Risk of Fracture in Type 2 Diabetes: a Nested, Case-Control Study

2020 ◽  
Author(s):  
Sarah Charlier ◽  
Janina Vavanikunnel ◽  
Claudia Becker ◽  
Susan S Jick ◽  
Christian Meier ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Case Control ◽  
Control Analysis ◽  
Newly Diagnosed ◽  
Antidiabetic Medication ◽  
Risk Of Fracture ◽  
Antidiabetic Treatment ◽  
Nested Case Control

Abstract Context Patients with type 2 diabetes mellitus (T2DM) have an increased risk of low-trauma fractures. However, the effect of antidiabetic medication in relation to glycemic control on the risk of fracture is poorly understood. Objective This work aimed to evaluate the association between the level of glycemic control, use of antidiabetic medication, and risk of low-trauma fractures in patients with newly diagnosed T2DM. Methods We conducted a nested case-control analysis among individuals registered in the Clinical Practice Research Datalink. The base population consisted of patients with newly diagnosed T2DM from 1995 to 2017. Cases were patients with a low-trauma fracture after T2DM diagnosis. We matched 4 controls to each case. Exposures of interest were glycemic control (last glycated hemoglobin [HbA1c] level before fracture) and type of diabetes treatment. We conducted conditional logistic regression analyses adjusted for several confounders. Results We identified 8809 cases and 35 219 controls. Patients with current metformin use and HbA1c levels of less than 7.0% and between 7.0-8.0% had a reduced risk of fractures (adjusted odds ratio 0.89; 95% CI, 0.83-0.96 and 0.81; 95% CI, 0.73-0.90, respectively) compared with untreated patients. However, in patients receiving metformin plus 1 or 2 other antidiabetic drugs, or insulin (alone or in addition to other antidiabetic medication), the level of glycemic control was not associated with the risk of fracture compared with untreated patients. Conclusions While patients with good or medium glycemic control receiving current metformin monotherapy had a lower risk of fracture compared with untreated patients, glycemic control in patients receiving treatment other than metformin was not associated with risk of fracture.

scholarly journals Impact of Diabetes Mellitus on Renal transplant outcome

2021 ◽  
pp. 057-064
Author(s):  
Abbasi Muhammad Tanzeel ◽  
Arif Mariam ◽  
Saleem Nayyar
Keyword(s):  
Diabetes Mellitus ◽  
Renal Transplant ◽  
Glycemic Control ◽  
Diabetic Patients ◽  
Renal Transplant Recipients ◽  
Post Transplant ◽  
Metabolic Complication ◽  
Wide Range ◽  
The Impact ◽  
Hba1c Levels

Diabetes Mellitus (DM) is a potent risk factor for post-transplant cardiovascular complications and infections. Management of diabetes and its complications in renal transplant recipients is a challenging task. This is a frequently encountered predicament in transplant setups. An erratic glycemic control during dialysis is a predictor of poor graft and patient outcomes after kidney transplantation. Literature review reveals majority studies explaining post-transplant diabetes and its role in graft and patient survival. However, a wide range of opinion exists about the impact of pre-transplant DM on transplant outcomes. Measurement of HbA1c levels is a significant tool for assessment of glycemic control. A target HbA1c level of <7% is recommended for diabetic patients irrespective of presence or absence of Chronic Kidney Disease (CKD). However, diabetic patients with CKD are at risk of hypoglycemia owing to decreased insulin metabolism so it is safe to keep HbA1c levels between 7-8% in this population. Immunosuppressive medications have a strong contributory role in deterioration of glycemic control. So, it is imperative to achieve strict pre-transplant diabetes control in order to avoid post-transplant complications. Post-transplant diabetes mellitus (PTDM) has been a subject of a large number of trials and is not only considered a serious metabolic complication but also a predisposing factor of diabetic nephropathy in transplanted kidney.

scholarly journals Type 2 Diabetes and Comorbidity Among Internal Medicine Lebanese Patients: A Case Control Study

2019 ◽  
pp. 1-7
Author(s):  
Salam Zein ◽  
Akram Echtay ◽  
Amal Al-Hajje ◽  
Batoul Diab ◽  
Dalia Khachman ◽  
...  
Keyword(s):  
Rating Scale ◽  
Case Control ◽  
University Hospital ◽  
Diabetic Patients ◽  
Risk Of Mortality ◽  
Patients With Diabetes ◽  
Comorbidity Index ◽  
Using Data ◽  
The Impact

Introduction: Comorbidity has been shown to increase length of stay (LOS), and mortality in diabetic patients. However, in Lebanon there is no data that studies the impact of comorbidity on mortality. Our aim was to assess whether comorbid conditions affect LOS and mortality in the sample under study. Study Design and Setting: A case-control retrospective pilot study was undertaken using data of patients admitted to Rafik Hariri University Hospital for six months. Comorbidity information was collected using Charlson Comorbidity Index (CCI), and Cumulative Illness Rating Scale (CIRS). Bivariate and multivariate analyses were conducted. Results: We studied 361 patients (33.2% were diabetic). In comparison to non-diabetic patients, diabetic patients had more comorbidity (5.28 vs 4.04; p <0.001), which was assessed by CIRS (p <0.001) and CCI (p <0.001). Non-diabetic patients have three times more risk of mortality than diabetic subjects, but the mean LOS for patients with diabetes was one day longer than patients without diabetes. Conclusion: These results showed that comorbidity increased both mortality and LOS, and it suggested that controlling diabetes and comorbidities may reduce mortality and LOS. However, they need to be confirmed by further investigations in a larger sample.

scholarly journals Association Between Glycemic Control and Risk of Fracture in Diabetic Patients: A Nested Case-Control Study

2019 ◽  
Vol 104 (5) ◽  
pp. 1645-1654 ◽  
Author(s):  
Janina Vavanikunnel ◽  
Sarah Charlier ◽  
Claudia Becker ◽  
Cornelia Schneider ◽  
Susan S Jick ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Case Control Study ◽  
Case Control ◽  
Diabetic Patients ◽  
Risk Of Fracture ◽  
Nested Case Control ◽  
Control Study

Characteristics of monitored diabetic patients by glycated haemoglobin (HbA1c)

2016 ◽  
Vol 5 (05) ◽  
pp. 4563
Author(s):  
Tariq A. Zafar
Keyword(s):  
Blood Glucose ◽  
Glycemic Control ◽  
Glycated Haemoglobin ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Age Group ◽  
Hba1c Test ◽  
Significant Difference ◽  
Tract Infections ◽  
The Impact

Glycated haemoglobin (HbA1c) test indicates the blood glucose levels for the previous two to three months. Using HbA1c test may overcome many of the practical issues and prevent infections such as urinary tract infections (UTIs). The study aimed to evaluate the impact of glycemic control using HbA1c test to understand patient characteristics and UTIs prevalence. Glycemic control was evaluated by measuring HbA1c for a total of 208 diabetes patients who were regularly attending diabetes center in Al-Noor specialist hospital in Makkah.  The results showed that good and moderate glycemic controlled patients were 14.9% and 16.9% respectively while the poor glycemic patients were 68.3%. Among the good improved glycemic control, 83.9% were females, 48.4% were from age group (15-44y). Among the moderately improved glycemic control, 68.4% were females, 54.3% were from age group (45-64 y) with no significant difference. The total number of the patients with positive UTIs was 55 (26.4%) while the total number of patients with negative was UTIs 153 (73.6%). Among the positive UTIs, 76.3% were with poor glycemic control while only 12.3% and 11% were moderate and good improved glycemic control respectively. Among the negative UTIs, 65.3% were with poor glycemic control while only 19% and 15.7% were with moderate and good improved glycemic control respectively.  Prevalence of UTIs among diabetic patients was not significant (p > 0.05). It was concluded that HbA1c was useful monitoring tool for diabetes mellitus and may lead to improved outcomes. Using a HbA1c test may overcome many of the practical issues that affect the blood glucose tests.

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