scholarly journals Association of cardiometabolic multimorbidity and depression with cardiovascular events in early-onset adult type 2 diabetes: a multi-ethnic study in the USA

2020 ◽  
Author(s):  
John Epoh Dibato ◽  
Olga Montvida ◽  
Francesco Zaccardi ◽  
Jack Alistair Sargeant ◽  
Melanie J Davies ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
Ethnic Groups ◽  
Early Onset ◽  
Age Groups ◽  
Atherosclerotic Cardiovascular Disease ◽  
Diabetes Diagnosis ◽  
Adult Type ◽  
The Usa

<b>Objective: </b>To evaluate the temporal patterns of cardiometabolic multimorbidity (CM) and depression in White Caucasian (WC) and African American (AA) with early-onset type 2 diabetes, and their impact on long-term Atherosclerotic Cardiovascular Disease (ASCVD). <p><b>Research Design and Methods: </b>From US electronic medical record, 101,104 AA and 505,336 WC subjects with type 2 diabetes diagnosis between 2000-2017 were identified (mean follow-up: 5.3 years). Among those without ASCVD at diagnosis, risk of ASCVD and MACE-3 (HF, myocardial infarction, or stroke) was evaluated between ethnicities by age groups. </p> <p><b>Results: </b>Proportion of patients diagnosed at <50 years increased during 2012-2017 (AA: 34-38%; WC: 26-29%). Depression prevalence increased during 2000-2017 (AA: 15-23%; WC: 20-34%) with an increasing trend for CM at diagnosis in both groups. </p> <p>Compared to WC, the adjusted MACE-3 risk was significantly higher in AA across all age groups, more pronounced in 18-39 years group (HR CI: 1.42-1.88) and in people with and without depression. AA had 17% (HR CI: 1.05-1.31) significantly higher adjusted ASCVD risk in the 18-39 years group only. Depression was independently associated with ASCVD and MACE-3 risk in both ethnic groups across all age groups. Other comorbidities were independently associated with ASCVD and MACE-3 risk only among WC. </p> <p><b>Conclusions: </b>AA have higher cardiovascular risk compared to WC, particularly in early-onset T2DM. CM and depression at diabetes diagnosis has been increasing over last two decades in both ethnic groups.<b> </b>Strategies for screening and optimal management of CM and depression particularly in early-onset T2DM may result in a lower cardiovascular risk. </p>

scholarly journals Association of cardiometabolic multimorbidity and depression with cardiovascular events in early-onset adult type 2 diabetes: a multi-ethnic study in the USA

2020 ◽  
Author(s):  
John Epoh Dibato ◽  
Olga Montvida ◽  
Francesco Zaccardi ◽  
Jack Alistair Sargeant ◽  
Melanie J Davies ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
Ethnic Groups ◽  
Early Onset ◽  
Age Groups ◽  
Atherosclerotic Cardiovascular Disease ◽  
Diabetes Diagnosis ◽  
Adult Type ◽  
The Usa

<b>Objective: </b>To evaluate the temporal patterns of cardiometabolic multimorbidity (CM) and depression in White Caucasian (WC) and African American (AA) with early-onset type 2 diabetes, and their impact on long-term Atherosclerotic Cardiovascular Disease (ASCVD). <p><b>Research Design and Methods: </b>From US electronic medical record, 101,104 AA and 505,336 WC subjects with type 2 diabetes diagnosis between 2000-2017 were identified (mean follow-up: 5.3 years). Among those without ASCVD at diagnosis, risk of ASCVD and MACE-3 (HF, myocardial infarction, or stroke) was evaluated between ethnicities by age groups. </p> <p><b>Results: </b>Proportion of patients diagnosed at <50 years increased during 2012-2017 (AA: 34-38%; WC: 26-29%). Depression prevalence increased during 2000-2017 (AA: 15-23%; WC: 20-34%) with an increasing trend for CM at diagnosis in both groups. </p> <p>Compared to WC, the adjusted MACE-3 risk was significantly higher in AA across all age groups, more pronounced in 18-39 years group (HR CI: 1.42-1.88) and in people with and without depression. AA had 17% (HR CI: 1.05-1.31) significantly higher adjusted ASCVD risk in the 18-39 years group only. Depression was independently associated with ASCVD and MACE-3 risk in both ethnic groups across all age groups. Other comorbidities were independently associated with ASCVD and MACE-3 risk only among WC. </p> <p><b>Conclusions: </b>AA have higher cardiovascular risk compared to WC, particularly in early-onset T2DM. CM and depression at diabetes diagnosis has been increasing over last two decades in both ethnic groups.<b> </b>Strategies for screening and optimal management of CM and depression particularly in early-onset T2DM may result in a lower cardiovascular risk. </p>

scholarly journals Association of Cardiometabolic Multimorbidity and Depression With Cardiovascular Events in Early-Onset Adult Type 2 Diabetes: A Multiethnic Study in the U.S.

Diabetes Care ◽  
2020 ◽  
Vol 44 (1) ◽  
pp. 231-239
Author(s):  
John Epoh Dibato ◽  
Olga Montvida ◽  
Francesco Zaccardi ◽  
Jack Alistair Sargeant ◽  
Melanie J. Davies ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Early Onset ◽  
Cardiovascular Events ◽  
Adult Type ◽  
The U.S

scholarly journals Potential cardiovascular benefits of GLP-1 analogues: evidence and implications for type 2 diabetes management

2020 ◽  
pp. 24-29
Author(s):  
M Vally
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
Paradigm Shift ◽  
Diabetes Management ◽  
Clinical Trial Data ◽  
Sglt2 Inhibitors ◽  
Atherosclerotic Cardiovascular Disease ◽  
Glucagon Like Peptide ◽  
Glucagon Like Peptide 1

Glucagon-like peptide-1 (GLP-1) analogues are an injectable therapy used in the management of type 2 diabetes. These drugs seem to reduce cardiovascular risk factors and clinical trial data seems to suggest that liraglutide and semaglutide reduce cardiovascular risk in patients with type 2 diabetes and concomitant atherosclerotic cardiovascular disease. The search for agents such as these (and SGLT2 inhibitors) that not only manage diabetes but also reduce cardiovascular risk has resulted in a paradigm shift in the way diabetes can be managed.

scholarly journals Positive Psychosocial Factors in Childhood Predicting Lower Risk for Adult Type 2 Diabetes: The Cardiovascular Risk in Young Finns Study, 1980–2012

2017 ◽  
Vol 52 (6) ◽  
pp. e157-e164 ◽  
Author(s):  
Laura Pulkki-Råback ◽  
Marko Elovainio ◽  
Christian Hakulinen ◽  
Jari Lipsanen ◽  
Laura D. Kubzansky ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
Psychosocial Factors ◽  
Lower Risk ◽  
Adult Type ◽  
Young Finns Study

scholarly journals Temporal Trends in Incident Hospitalization for Diabetes-Related Foot Ulcer in Type 2 Diabetes: The Fremantle Diabetes Study

2021 ◽  
Author(s):  
Emma J Hamilton ◽  
Wendy A Davis ◽  
Ranita Siru ◽  
Mendel Baba ◽  
Paul E Norman ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Proportional Hazards ◽  
Temporal Trends ◽  
Age Groups ◽  
Foot Ulcer ◽  
Cox Proportional Hazards ◽  
Diabetes Diagnosis ◽  
Incident Rate

Objective:<b> </b>To determine whether, reflecting trends in other chronic complications, incident hospitalization for diabetes-related foot ulcer (DFU) has declined over recent decades in type 2 diabetes. <p>Research design and methods:<b> </b>Participants with type 2 diabetes from the community-based Fremantle Diabetes Study Phases I (FDS1; 1,296 participants, mean age 64.0 years, 48.6% males, recruited 1993-1996) and II (FDS2; 1,509 participants, mean age 65.4 years, 51.8% males, recruited 2008-2011) were followed from entry to first hospitalization for/with DFU, death or 5 years (whichever came first). Incident rate ratios (IRRs) and incident rate differences (IRDs) were calculated for FDS2 versus FDS1 overall and in 10-year age-groups. Cox proportional hazards modelling determined independent predictors of first DFU hospitalization in the combined cohort.</p> <p>Results:<b> </b>Incident DFU hospitalization (95% CI) was 1.9 (0.9-3.3) /1,000 person-years in FDS1 during 5,879 person-years of follow-up, and 4.5 (3.0-6.4) /1,000 person-years in FDS2 during 6,915 person-years of follow-up. The crude IRR (95% CI) was 2.40 (1.17-5.28), <i>P</i>=0.013) and IRD 2.6 (0.7-4.5) /1,000 person-years (<i>P</i>=0.010). The highest incidence rate (IR) for any age-group was 23.6/1,000 person-years in FDS2 participants aged 31-40 years. Age at diabetes diagnosis (inverse), HbA<sub>1c</sub>, insulin use, height, ln(urinary albumin:creatinine), absence of any foot pulse, previous peripheral revascularization and peripheral sensory neuropathy (PSN) were independent predictors of incident hospitalization for/with DFU.</p> <p>Conclusions:<b> </b>Incident DFU hospitalizations complicating type 2 diabetes increased between FDS Phases, especially in younger participants, and were more likely in those with PSN, peripheral arterial disease and suboptimal glycemic control at baseline.</p>

scholarly journals Prevalence and incidence of type 2 diabetes in Iceland 2005-2018

2021 ◽  
Vol 107 (05) ◽  
pp. 227-233
Author(s):  
Bolli Þórsson ◽  
◽  
Elías Freyr Guðmundsson ◽  
Gunnar Sigurðsson ◽  
Thor Aspelund ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Age Groups ◽  
Similar Rate ◽  
Population Based ◽  
National Database ◽  
Published Data ◽  
Prescription Database ◽  
Men And Women ◽  
The Usa

INTRODUCTION: The number of people with type 2 diabetes has increased in Iceland in the last few decades. We utilized the national database on prescribed medication from the Directorate of Health to estimate the prevalence and incidence of type 2 diabetes in Iceland and made prediction on the prevalence of type 2 diabetes in Iceland in 10 and 20 years. MATERIAL AND METHODS: Prevalence and incidence of type 2 diabetes for the period 2005-2018 was estimated based on prescriptions of diabetes medication in the national prescription database containing all prescriptions in Iceland during the period. The result was compared to the result from the REFINE-Reykjavik study (prospective, population-based cohort study) from 2004 to 2011 and published data from the USA from 1980 to 2016. RESULTS: The prevalence of type 2 diabetes more than doubled in near all age groups in both men and women in the period 2005-2018. The incidence increased by 2.8% annually (in 18-79 years old). The number of people in Iceland with type 2 diabetes was 10600 in 2018 and had increased from 4200 in the year 2005. Comparison with the results of the REFINE-Reykjavik study showed an underestimation (29% in men and women) of the prevalence of type 2 diabetes. If the increase in type 2 diabetes continues at a similar rate as in the years 2005-2018 the number of people with diabetes in Iceland could be near 24000 in the year 2040. CONCLUSION: Linear increase was seen in incidence and prevalence of people with type 2 diabetes in the years 2005-2018. Similar evolution was seen in USA from 1984. In order to counteract the increase of type 2 diabetes following the same path as has been seen in the USA, targeted measures are needed.

scholarly journals Cardiovascular Outcomes of Antidiabetes Medications by Race/Ethnicity: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Xiaoling Cai ◽  
Sam Dagogo-Jack ◽  
Chu Lin ◽  
Wenjia Yang ◽  
Linong Ji
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
Risk Reduction ◽  
Ethnic Groups ◽  
Meta Analysis ◽  
Cardiovascular Outcomes ◽  
Control Treatment ◽  
Cardiovascular Risk Reduction ◽  
Racial Ethnic

Abstract Background: The consistency of cardiovascular risk reduction by antidiabetes medications across racial and ethnic groups remains unclear. The aim of this study was to analyze racial/ethnic patterns in the results of cardiovascular outcomes trials of antidiabetes medications in people with type 2 diabetes.Method: PubMed and Cochrane library databases were searched from the inception dates to December 2019. Cardiovascular outcome trials in type 2 diabetes that randomized participants to active or control treatment and reported results by race/ethnic groups or region were included.Results: A total of 16 studies were included in this meta-analysis. Among White participants, active antidiabetes medication, compared with control treatment, significantly decreased the composite cardiovascular outcomes (OR=0.90, 95% CI 0.86-0.94, p<0.05). Among Asian participants, active antidiabetes medication, compared with control treatment, also significantly decreased the composite cardiovascular outcomes (OR=0.82, 95%CI 0.76-0.90, p<0.05). Among Black participants (OR=0.96, 95% CI 0.69-1.32, p=0.79) and subjects from other groups (mostly Hispanics or Pacific Islanders) (OR=0.92, 95% CI 0.81-1.04, p=0.16), active anti-diabetes medication resulted in nominal but non-significant decreases in the composite cardiovascular outcomes, compared with the control treatment.Conclusions: Antidiabetes drugs demonstrated cardiovascular safety in people with type 2 diabetes from all racial/ethnic groups studied, but achieved significant composite cardiovascular risk reduction only in White and Asian participants, perhaps due to differences in sample size and power.

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