scholarly journals Association of Glycemia, Lipids, and Blood Pressure With Cognitive Performance in People With Type 2 Diabetes in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study

2021 ◽  
Author(s):  
José A. Luchsinger ◽  
Naji Younes ◽  
Jennifer J. Manly ◽  
Joshua Barzilay ◽  
Willy Valencia ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Comparative Effectiveness ◽  
Verbal Learning ◽  
Digit Symbol Substitution Test ◽  
Effectiveness Study ◽  
Cross Sectional ◽  
Comparative Effectiveness Study ◽  
Statin Use

Objective: Type 2 diabetes is a risk factor for cognitive impairment. We examined the relation of glycemia, lipids, blood pressure (BP), hypertension history, and statin use with cognition in the Glycemia Reduction Approaches in Diabetes: a comparative effectiveness study (GRADE). <p>Research Design and Methods: Cross-sectional analyses from GRADE at baseline examined the association of glycemia (hemoglobin A1c [HbA1c]), LDL, systolic (SBP) and diastolic (DBP) BP, hypertension history, and statin use with cognition assessed by the Spanish English Verbal Learning Test (SEVLT), letter (LF) and animal fluency (AF) tests, and Digit Symbol Substitution Test (DSST). </p> <p>Results: Among 5,047 GRADE participants, 5,018 (99.4)% completed cognitive assessments. Their mean age was 56.7 ± 10.0 years, 36.4% were women. Mean diabetes duration was 4.0 ± 2.7 years. HbA1c was not related to cognition. Higher LDL was related to modestly worse DSST scores whereas statin use was related to modestly better DSST scores. SBP between 120 and 139 mmHg and DBP between 80 and 89 mmHg were related to modeslty better DSST scores. Hypertension history was not related to cognition. </p> <p>Conclusions: In persons with type 2 diabetes with a mean duration of less than 5 years, lower LDL and statin use were related to modestly better executive cognitive function. SBP levels in the range of 120 to 139 mmHg, and DBP levels in the range of 80 to 89 mmHg, but not lower levels, were related to modeslty better executive function. These differences may not be clinically significant. </p> <p> </p>

scholarly journals Association of Glycemia, Lipids, and Blood Pressure With Cognitive Performance in People With Type 2 Diabetes in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study

2021 ◽  
Author(s):  
José A. Luchsinger ◽  
Naji Younes ◽  
Jennifer J. Manly ◽  
Joshua Barzilay ◽  
Willy Valencia ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Comparative Effectiveness ◽  
Verbal Learning ◽  
Digit Symbol Substitution Test ◽  
Effectiveness Study ◽  
Cross Sectional ◽  
Comparative Effectiveness Study ◽  
Statin Use

Objective: Type 2 diabetes is a risk factor for cognitive impairment. We examined the relation of glycemia, lipids, blood pressure (BP), hypertension history, and statin use with cognition in the Glycemia Reduction Approaches in Diabetes: a comparative effectiveness study (GRADE). <p>Research Design and Methods: Cross-sectional analyses from GRADE at baseline examined the association of glycemia (hemoglobin A1c [HbA1c]), LDL, systolic (SBP) and diastolic (DBP) BP, hypertension history, and statin use with cognition assessed by the Spanish English Verbal Learning Test (SEVLT), letter (LF) and animal fluency (AF) tests, and Digit Symbol Substitution Test (DSST). </p> <p>Results: Among 5,047 GRADE participants, 5,018 (99.4)% completed cognitive assessments. Their mean age was 56.7 ± 10.0 years, 36.4% were women. Mean diabetes duration was 4.0 ± 2.7 years. HbA1c was not related to cognition. Higher LDL was related to modestly worse DSST scores whereas statin use was related to modestly better DSST scores. SBP between 120 and 139 mmHg and DBP between 80 and 89 mmHg were related to modeslty better DSST scores. Hypertension history was not related to cognition. </p> <p>Conclusions: In persons with type 2 diabetes with a mean duration of less than 5 years, lower LDL and statin use were related to modestly better executive cognitive function. SBP levels in the range of 120 to 139 mmHg, and DBP levels in the range of 80 to 89 mmHg, but not lower levels, were related to modeslty better executive function. These differences may not be clinically significant. </p> <p> </p>

scholarly journals Cardiovascular Events, Acute Hospitalizations, and Mortality in Patients With Type 2 Diabetes Mellitus Who Initiate Empagliflozin Versus Liraglutide: A Comparative Effectiveness Study

2021 ◽  
Author(s):  
Reimar W. Thomsen ◽  
Jakob S. Knudsen ◽  
Johnny Kahlert ◽  
Lisbeth M. Baggesen ◽  
Maria Lajer ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Comparative Effectiveness ◽  
Loop Diuretic ◽  
Major Adverse Cardiac Events ◽  
Effectiveness Study ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Comparative Effectiveness Study

Background In cardiovascular outcome trials, the sodium glucose cotransporter 2 inhibitor empagliflozin and glucagon‐like peptide‐1 (GLP‐1) receptor agonist liraglutide caused similar reductions in major adverse cardiac events (MACE). We compared clinical outcomes in routine clinical care. Methods and Results EMPLACE (Cardiovascular and Renal Outcomes, and Mortality in Danish Patients with Type 2 Diabetes Who Initiate Empagliflozin Versus GLP‐1RA: A Danish Nationwide Comparative Effectiveness Study) is an ongoing nationwide population‐based comparative effectiveness cohort study in Denmark. For the present study, we included 14 498 new users of empagliflozin and 12 706 new users of liraglutide, 2015 to 2018. Co‐primary outcomes were expanded major adverse cardiac events (stroke, myocardial infarction, unstable angina, coronary revascularization, hospitalization for heart failure [HHF], or all‐cause death); HHF or all‐cause death; and first HHF or first initiation of loop‐diuretic therapy. Secondary outcomes included all‐cause hospitalization or death. We applied propensity score balancing and Cox regression to compute adjusted hazard ratios (aHRs) in on‐treatment (OT) and intention‐to‐treat (ITT) analyses. Cohorts were well balanced at baseline (median age 61 years, 59% men, diabetes mellitus duration 6.6 years, 30% with preexisting cardiovascular disease). During mean follow‐up of 1.1 years in OT and 1.5 years in ITT analyses, empagliflozin versus liraglutide was associated with a similar rate of expanded major adverse cardiac events (OT aHR, 1.02; 95% CI, 0.91–1.14; ITT aHR, 1.06; 95% CI, 0.96–1.17), and HHF or all‐cause death (OT aHR, 0.97; 95% CI, 0.85–1.11; ITT aHR, 1.02; 95% CI, 0.91–1.14); and a decreased rate of a first incident HHF or loop‐diuretic initiation (OT aHR, 0.80; 95% CI, 0.68–0.94; ITT aHR, 0.87; 95% CI, 0.76–1.00), and of all‐cause hospitalization or death (OT aHR, 0.93; 95% CI, 0.89–0.98; ITT aHR, 0.93; 95% CI, 0.90–0.97). Conclusions Empagliflozin and liraglutide initiators had comparable rates of expanded major adverse cardiac events, and HHF or all‐cause death, whereas empagliflozin initiators had a lower rate of a first HHF or loop‐diuretic initiation.

Sign in / Sign up

Export Citation Format

Share Document