scholarly journals Phenotyping Individuals With Newly-Diagnosed Type 2 Diabetes at Risk for All-Cause Mortality: A Single Centre Observational, Prospective Study

2020 ◽  
Author(s):  
Edoardo Biancalana ◽  
Federico Parolini ◽  
Alessandro Mengozzi ◽  
Anna Solini
Keyword(s):  
Type 2 Diabetes ◽  
Mortality Rate ◽  
Disease Duration ◽  
Previous History ◽  
Newly Diagnosed ◽  
Time Data ◽  
Short Disease Duration ◽  
All Cause Mortality

Abstract Background Type 2 diabetes (T2D) shows a high mortality rate, dependent on disease duration, comorbidities and glucose control over time. Data on patients with short disease duration are scanty.Methods We prospectively followed a cohort of newly-diagnosed T2D patients referring to a single diabetes centre, treated according to the international guidelines and checked every 6-12 months. All-cause mortality and major cardiovascular (CV) events were registered.Results 289 patients out of 3019 consecutive first attendances matched inclusion criteria and were included in the observation. Mean follow-up was 51.2 months. At 31 December 2018, 253 patients were alive and 36 deceased. At baseline, deceased individuals were older, with lower eGFR and lower uric acid, higher prevalence of atrial fibrillation. During the follow-up, 18 non-fatal CV events were adjudicated; patients with incident CV disease (CVD) differed at baseline for sex, previous history of CVD and retinopathy, higher use of secretagogues and lower use of metformin. At multivariate analysis, age and previous CVD were the only independent determinants of all-cause mortality and incident CVD, respectively. In deceased individuals, eGFR slope was markedly unstable and ΔeGFR at the end of the follow-up was higher (p<0.001), and predicted mortality. Conclusion Newly-diagnosed T2D patients followed according to the best clinical practice show a mortality rate similar to that reported in more complicated patients with longer disease duration; none of the clinical and biochemical variables commonly measured at baseline can predict mortality or incident CVD; early metformin use seems to be associated with no risk of prevalent or incident retinopathy.

scholarly journals Phenotyping Individuals With Newly-Diagnosed Type 2 Diabetes at Risk for All-Cause Mortality: A Single Centre Observational, Prospective Study

2020 ◽  
Author(s):  
Edoardo Biancalana ◽  
Federico Parolini ◽  
Alessandro Mengozzi ◽  
Anna Solini
Keyword(s):  
Type 2 Diabetes ◽  
Mortality Rate ◽  
Disease Duration ◽  
Previous History ◽  
Newly Diagnosed ◽  
Time Data ◽  
Short Disease Duration ◽  
All Cause Mortality

Abstract Background Type 2 diabetes (T2D) shows a high mortality rate, dependent on disease duration, comorbidities and glucose control over time. Data on patients with short disease duration are scanty. Methods We prospectively followed a cohort of newly-diagnosed T2D patients referring to a single diabetes centre, treated according to the international guidelines and checked every 6-12 months. All-cause mortality and major cardiovascular (CV) events were registered. Results 289 patients out of 3019 consecutive first attendances matched inclusion criteria and were included in the observation. Mean follow-up was 51.2 months. At 31 December 2018, 253 patients were alive and 36 deceased. At baseline, deceased individuals were older, with lower eGFR and lower uric acid, higher prevalence of atrial fibrillation. During the follow-up, 18 non-fatal CV events were adjudicated; patients with incident CV disease (CVD) differed at baseline for sex, previous history of CVD and retinopathy, higher use of secretagogues and lower use of metformin. At multivariate analysis, age and previous CVD were the only independent determinants of all-cause mortality and incident CVD, respectively. In deceased individuals, eGFR slope was markedly unstable and ΔeGFR at the end of the follow-up was higher (p<0.001), and predicted mortality. Conclusion Newly-diagnosed T2D patients followed according to the best clinical practice show a mortality rate similar to that reported in more complicated patients with longer disease duration; none of the clinical and biochemical variables commonly measured at baseline can predict mortality or incident CVD; early metformin use seems to be associated with no risk of prevalent or incident retinopathy.

453-P: Metabolic Syndrome Severity Score, All-Cause Mortality, and Incident Vascular Events in Type 2 Diabetes: A 13-Year, Single-Centre, Follow-Up Study

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 453-P
Author(s):  
MONIA GAROFOLO ◽  
ELISA GUALDANI ◽  
DANIELA LUCCHESI ◽  
LAURA GIUSTI ◽  
VERONICA SANCHO-BORNEZ ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Severity Score ◽  
Single Centre ◽  
Vascular Events ◽  
Follow Up Study ◽  
All Cause Mortality

scholarly journals Patients characteristics associated with better glycemic response to teneligliptin and metformin therapy in type 2 diabetes: a retrospective study

2018 ◽  
Vol 5 (2) ◽  
pp. 424
Author(s):  
Pradeep V. Gadge ◽  
Roshani P. Gadge ◽  
Nikita D. Paralkar
Keyword(s):  
Type 2 Diabetes ◽  
Body Mass Index ◽  
Retrospective Study ◽  
Blood Sugar ◽  
Therapeutic Effectiveness ◽  
Glycemic Response ◽  
Newly Diagnosed ◽  
Long Duration

Background: Teneligliptin was recently approved for type 2 diabetes (T2D) management in India and is used as monotherapy or in combination with different antidiabetic drugs. The aim of this study was to identify patients’ characteristics associated with better glycemic response to teneligliptin and metformin.Methods: A retrospective analysis of data was performed in patients of T2D with HbA1c above 7% who were treated with teneligliptin 20 mg/d as add on to metformin (500-100 mg/d) and whose follow-up data at 12-weeks was available. Fasting blood sugar (FBS) and post-prandial blood sugar (PPBS) changes were analysed.  Results: Among 66 patients included in analysis, mean age was 61.0±9.8 years and 53% were females. Median duration of diabetes was 2 years. At 12-weeks, a significant reduction PPBS was observed (mean change: -14.3 mg/dL, p=0.009) but not in FBS (mean change: -2.4 mg/dL, p=0.353). Among different patients’ characteristics, age ≤60 years (p=0.006), duration of ≤1 year (p=0.023), body-mass index ≥25 kg/m2 (p=0.009), presence of dyslipidemia (p=0.05) and absence of complications (p=0.012) were associated with significant reduction in PPBS but not in FBS.Conclusions: A younger, newly-diagnosed, obese T2D patients with dyslipidemia without any complications of diabetes can derive better therapeutic effectiveness from teneligliptin added to metformin. These findings need to be confirmed in large, prospective, long duration study.  

scholarly journals Testosterone deficiency is associated with increased risk of mortality and testosterone replacement improves survival in men with type 2 diabetes

2013 ◽  
Vol 169 (6) ◽  
pp. 725-733 ◽  
Author(s):  
Vakkat Muraleedharan ◽  
Hazel Marsh ◽  
Dheeraj Kapoor ◽  
Kevin S Channer ◽  
T Hugh Jones
Keyword(s):  
Type 2 Diabetes ◽  
Untreated Group ◽  
Testosterone Replacement ◽  
Testosterone Deficiency ◽  
Testosterone Levels ◽  
All Cause Mortality ◽  
Low Testosterone

ObjectiveMen with type 2 diabetes are known to have a high prevalence of testosterone deficiency. No long-term data are available regarding testosterone and mortality in men with type 2 diabetes or any effect of testosterone replacement therapy (TRT). We report a 6-year follow-up study to examine the effect of baseline testosterone and TRT on all-cause mortality in men with type 2 diabetes and low testosterone.Research design and methodsA total of 581 men with type 2 diabetes who had testosterone levels performed between 2002 and 2005 were followed up for a mean period of 5.8±1.3 s.d. years. Mortality rates were compared between total testosterone >10.4 nmol/l (300 ng/dl; n=343) and testosterone ≤10.4 nmol/l (n=238). The effect of TRT (as per normal clinical practise: 85.9% testosterone gel and 14.1% intramuscular testosterone undecanoate) was assessed retrospectively within the low testosterone group.ResultsMortality was increased in the low testosterone group (17.2%) compared with the normal testosterone group (9%; P=0.003) when controlled for covariates. In the Cox regression model, multivariate-adjusted hazard ratio (HR) for decreased survival was 2.02 (P=0.009, 95% CI 1.2–3.4). TRT (mean duration 41.6±20.7 months; n=64) was associated with a reduced mortality of 8.4% compared with 19.2% (P=0.002) in the untreated group (n=174). The multivariate-adjusted HR for decreased survival in the untreated group was 2.3 (95% CI 1.3–3.9, P=0.004).ConclusionsLow testosterone levels predict an increase in all-cause mortality during long-term follow-up. Testosterone replacement may improve survival in hypogonadal men with type 2 diabetes.

scholarly journals Association between On-Treatment Haemoglobin A1c and All-Cause Mortality in Individuals with Type 2 Diabetes: Importance of Personalized Goals and Type of Anti-Hyperglycaemic Treatment

2020 ◽  
Vol 9 (1) ◽  
pp. 246
Author(s):  
Emanuela Orsi ◽  
Enzo Bonora ◽  
Anna Solini ◽  
Cecilia Fondelli ◽  
Roberto Trevisan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Haemoglobin A1c ◽  
Vital Status ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Severe Comorbidity ◽  
Potential Risks ◽  
Risk Of Treatment

The increased mortality reported with intensive glycaemic control has been attributed to an increased risk of treatment-related hypoglycaemia. This study investigated the relationships of haemoglobin (Hb) A1c, anti-hyperglycaemic treatment, and potential risks of adverse effects with all-cause mortality in patients with type 2 diabetes. Patients (n = 15,773) were stratified into four categories according to baseline HbA1c and then assigned to three target categories, based on whether HbA1c was ≤0.5% below or above (on-target), >0.5% below (below-target) or >0.5% above (above-target) their HbA1c goal, personalized according to the number of potential risks among age > 70 years, diabetes duration > 10 years, advanced complication(s), and severe comorbidity (ies). The vital status was retrieved for 15,656 patients (99.26%). Over a 7.4-year follow-up, mortality risk was increased among patients in the highest HbA1c category (≥8.5%) (adjusted hazard ratio, 1.34 (95% confidence interval, 1.22–1.47), p < 0.001) and those above-target (1.42 (1.29–1.57), p < 0.001). Risk was increased among individuals in the lowest HbA1c category (<6.5%) and those below-target only if treated with agents causing hypoglycaemia (1.16 (1.03–1.29), p = 0.01 and 1.10 (1.01–1.22), p = 0.04, respectively). These data suggest the importance of setting both upper and lower personalized HbA1c goals to avoid overtreatment in high-risk individuals with type 2 diabetes treated with agents causing hypoglycaemia.

scholarly journals Health Care Utilization Following Newly-Diagnosed Type-2 Diabetes in Sweden: A Follow-Up of 38,956 Patients in a Real Clinical Setting

2013 ◽  
Vol 16 (7) ◽  
pp. A451
Author(s):  
U. Sabale ◽  
J. Bodegård ◽  
J. Sundström ◽  
B. Svennblad ◽  
C.J. Östgren ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Health Care Utilization ◽  
Clinical Setting ◽  
Care Utilization ◽  
Newly Diagnosed

scholarly journals Anxiety and Depressive Symptoms as Predictors of All-Cause Mortality among People with Insulin-Naïve Type 2 Diabetes: 17-Year Follow-Up of the Second Nord-Trøndelag Health Survey (HUNT2), Norway

PLoS ONE ◽  
2016 ◽  
Vol 11 (8) ◽  
pp. e0160861 ◽  
Author(s):  
Marjolein M. Iversen ◽  
Giesje Nefs ◽  
Grethe S. Tell ◽  
Birgitte Espehaug ◽  
Kristian Midthjell ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Depressive Symptoms ◽  
Health Survey ◽  
All Cause Mortality

scholarly journals C-peptide and the risk for incident complications and mortality in type 2 diabetic patients: a retrospective cohort study after a 14-year follow-up

2012 ◽  
Vol 167 (2) ◽  
pp. 173-180 ◽  
Author(s):  
S Bo ◽  
L Gentile ◽  
A Castiglione ◽  
V Prandi ◽  
S Canil ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Retrospective Cohort ◽  
Microvascular Complications ◽  
Chronic Complications ◽  
C Peptide ◽  
All Cause Mortality

ObjectiveC-peptide, a cleavage product of insulin, exerts biological effects in patients with type 1 diabetes mellitus, but its role in type 2 diabetes mellitus is controversial. Our aim was to examine the associations between fasting C-peptide levels and all-cause mortality, specific-cause mortality and the incidence of chronic complications in patients with type 2 diabetes.DesignRetrospective cohort study with a median follow-up of 14 years.MethodsA representative cohort of 2113 patients with type 2 diabetes mellitus and a subgroup of 931 individuals from this cohort without chronic complications at baseline from a diabetic clinic were studied.ResultsPatients with higher C-peptide levels had higher baseline BMI and triglyceride and lower HDL-cholesterol values. During the follow-up, 46.1% of the patients died. In a Cox proportional hazard model, after multiple adjustments, no significant association was found between the C-peptide tertiles and all-cause mortality or mortality due to cancer, diabetes or cardiovascular diseases. In the subgroup of 931 patients without chronic complications at baseline, the incidence of microvascular complications decreased from the first to the third C-peptide level tertile, while the incidence of cardiovascular disease did not differ. The risks for incident retinopathy (hazard ratio (HR)=0.33; 95% confidence interval (CI) 0.23–0.47), nephropathy (HR=0.27; 95% CI 0.18–0.38) and neuropathy (HR=0.39; 95% CI 0.25–0.61) were negatively associated with the highest C-peptide tertile, after adjusting for multiple confounders.ConclusionsHigher baseline C-peptide levels were associated with a reduced risk of incident microvascular complications but imparted no survival benefit to patients with type 2 diabetes mellitus.

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