Risk Of Diabetes Mellitus In Patients Research Articles

Diabetes mellitus in rheumatic diseases: clinical characteristics and treatment considerations.

New pathophysiological insights are now available on comorbidities in rheumatic diseases (RDs). Several nationwide studies point to the fact that comorbid diabetes mellitus (DM) increases the risk of adverse outcomes in patients with various RDs. Genetic factors, intensity of systemic inflammation, anti-inflammatory potential of therapeutic agents, and duration of RDs have been insufficiently explored in the context of comorbidities. Some disease-modifying antirheumatic drugs (DMARDs) have demonstrated a potential to improve the glycemic control while glucocorticoids (GCs) have worsened it, particularly in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Anti-TNFalpha agents in combination with hydroxychloroquine (HCQ) have been associated with a reduced risk of DM in patients with RA, ankylosing spondylitis (AS), Sjögren syndrome (SS), and SLE. Better understanding of confounding factor of currently available antirheumatic therapies in patients with DM and RDs willpave the way for a tailored approach, limiting the severity of clinical manifestations and reducing the mortality risk.

Association between Statin Use and Diabetes Risk in Patients with Transient Ischemic Attack.

Statin therapy can effectively reduce recurrent transient ischemic attack (TIA) risk. However, studies have reported that statin use is associated with incidence of diabetes mellitus (DM). Whether statin therapy remains associated with higher DM risk in patients with TIA remains unknown. This study investigated whether statin treatment influences incident DM risk in patients with TIA. We conducted a retrospective cohort study using the Longitudinal Health Insurance Database 2000. Participants who were newly diagnosed with TIA (ICD-9-CM code 435) from 1 January 1997 to 31 December 2011 were recruited. The Kaplan-Meier method and Cox proportional risk model of time-dependent covariance were used. We enrolled 8342 patients with newly diagnosed TIA from 1 January 1997 to 31 December 2011. Of these, 1255 patients were classified as statin users and 7087 as nonusers. During the 14-year follow-up, the incidence of newly diagnosed DM was 0.545-fold lower in the statins group compared with nonusers (95% confidence interval [CI] = 0.457-0.650). According to cumulative defined daily doses (cDDDs), the adjusted hazard ratios for DM were 0.689, 0.594, and 0.463 when patients were treated with statins at cDDDs = 28-89, 90-180, and >180, respectively. In patients with TIA, statin use is associated with a lower incident DM risk compared with the nonuse of statins.

Association between Age-Related Macular Degeneration and the Risk of Diabetes Mellitus: A Nationwide Cohort Study.

Age-related macular degeneration (AMD) is a degenerative and progressive disease of the macula, the part of the retina that is responsible for central vision. AMD shares some risk factors with diabetes mellitus (DM), but little is known about the risk of DM in individuals with AMD. With the goal of establishing novel perspectives, this study aimed to investigate the association between AMD and the risk of DM using the Korean Nationwide Health Insurance Database. Individuals aged ≥ 50 years who underwent a national health screening program in 2009 were enrolled. Participants were categorized by the presence of AMD and visual disability (VD). The Cox hazard regression model was used to examine hazard ratios (HRs) of DM with adjustment for potential confounders. Stratified analyses by age, sex, and comorbidities (hypertension or dyslipidemia) were also performed. During a mean follow-up of 8.61 years, there were 403,367 (11.76%) DM incidences among the final 3,430,532 participants. The crude HR (95% confidence interval (CI)) was 1.16 (1.13–1.20) for AMD. After adjusting for potential confounders, AMD was associated with a 3% decreased risk of DM (aHR 0.97, 95% CI 0.95–1.00), but no significant association with the risk of DM was found in AMD with VD (aHR 1.03, 95% CI 0.93–1.14). In summary, we did not find an increased risk of DM in individuals with AMD. A 3% decreased risk of DM in patients with AMD is not clinically meaningful. Our study suggests that the association between AMD and the risk of DM is weak, considering the potential confounders. Further studies examining this association are needed to extend our knowledge.

Hydroxychloroquine lowers the risk for Diabetes Mellitus in patients with Systemic Lupus Erythematosus

BackgroundPrevious literature suggests a lower prevalence of diabetes mellitus (DM) in patients with systemic lupus erythematosus (SLE). Study questionWe aimed to investigate the impact of hydroxychloroquine (HCQ) on the risk of DM in patients with SLE. Study designWe queried The TriNetX database for all patients aged >18 years diagnosed with SLE from January 1, 2000, until January 1, 2021. We identified patients with SLE using disease–specific International Classification of Diseases, Tenth Revision (ICD-10) diagnosis code (M32). At the time of enrollment, we excluded all patients who were diagnosed with diabetes mellitus (ICD-10 code: E08-E13) either prior to or at the initial visit. Measures and outcomesPatients were classified into two groups according to treatment with HCQ. The primary objective was to compare the impact of HCQ over a consecutive 10-year period on the risk of DM in an SLE population. ResultsFollowing propensity matching an equal cohort, 19025 SLE patients on HCQ and 19025 SLE controls, were included with a mean period of follow-up of 10 years. Patients who were adherent to HCQ had lower rates of DM (event rate: 13.3% vs 18.5%) with relative risk (RR) 72.0% (68.7% to 75.4%). In Kaplan-Meier survival analysis the cumulative probability of survival was significantly higher in the HCQ subjects compared to control (78.1% vs 68.3%; log-rank, p<0.001). ConclusionWe provide further evidence for the antidiabetic effect of hydroxychloroquine in a lupus cohort. We suggest a unifying hypothesis linking the pharmacologic effect of hydroxychloroquine with its favorable effects on glucose metabolism.

Hemoglobin A1c in combination with fasting plasma glucose trumps fasting plasma glucose alone as predictive indicators for diabetes mellitus: an ambidirectional cohort study of Thai people with impaired fasting glucose

IntroductionThis ambidirectional cohort study aimed to assess the performance of combining hemoglobin A1c (HbA1c) to fasting plasma glucose (FPG) for estimation of progression rate to diabetes mellitus (DM) and to...

Role of Advanced Glycation End Products in Assessment of Diabetes Mellitus as a Risk Factor for Retinal Vein Occlusion

Aim: In this study, we aimed to assess the correlation between diabetes mellitus (DM) and the retinal vein occlusion (RVO) based on skin autofluorescence (SAF) measurement, which reflects the accumulation of advanced glycation end products (AGE) in patients who have undergone an episode of central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO). Material and methods: In total, 23 patients (16 males, 7 females) with RVO were included in this study. Among these 23 participants, 12 (52%) had been diagnosed with CRVO and 11 (48%) with BRVO. The control group consisted of 14 healthy volunteers (11 females, 3 males). To calculate the risk of cardiovascular diseases (CVD) and DM, we conducted SAF examinations. We compared the SAF levels in three groups of patients: (1) with CRVO, (2) with BRVO, and (3) the control group. Basic demographic and clinical information and detailed history of the concurrent diagnoses of systemic diseases, such as systemic hypertension (HTN), DM, hyperlipidemia (HL), and heart diseases, were obtained. Results: In total, 10 (43.5%) patients were diagnosed with DM, 6 (55%) in the BRVO group and 4 (33%) in the CRVO group. The mean SAF value was significantly higher in the BRVO group than in the control group (2.64 a.u. and 2.35 a.u., respectively) (p = 0.023). More patients with risk of DM were identified in the CRVO group than in the BRVO group (p = 0.024). Conclusions: The advanced glycation end products (AGE) in the skin autofluorescence (SAF) is a viable method of evaluating the risk of DM in patients with RVO. We confirmed a correlation between RVO and DM, which was significantly pronounced in the CRVO form, although further carefully devised studies on the relationship between RVO and DM with a larger number of responders should be conducted in the future.

Risk of diabetes mellitus in patients with prostate cancer receiving injection therapy: A nationwide population-based propensity score-matched study.

We aimed to investigate whether the risk of diabetes mellitus (DM) is heightened in patients with prostate cancer receiving injection therapy. Men diagnosed with prostate cancer between 2000 and 2012 were included in the case cohort, and men without prostate cancer were included as controls. Each patient with prostate cancer was matched with a control patient with the same index year, demographic variables and comorbidities, and comparisons were made using propensity score matching. The hazard ratio of DM was estimated using the Cox proportional hazards model. This cohort study consisted of 1213 patients with prostate cancer and 1213 control patients. The risk of DM in patients with prostate cancer was 1.60 times (95% CI = 1.12, 2.27) that of patients without prostate cancer. Compared with the controls, the hazard ratios of DM for patients with prostate cancer not receiving oral hormone therapy, patients with prostate cancer receiving oral hormone therapy, and patients with prostate cancer not receiving injection hormone therapy were 1.65 (95% CI = 1.01, 2.70), 1.57 (95% CI = 1.07, 2.70), and 1.94 (95% CI = 1.34, 2.81), respectively. The risk of DM in patients who received injection hormone therapy was 0.45 times (95% CI = 0.25, 0.82) that of patients who did not receive injection hormone therapy. Patients with prostate cancer had an increased risk of DM compared with patients without prostate cancer. Patients with prostate cancer who received injection therapy had a lower risk of DM compared with those who did not.

The risk of chronic kidney disease and diabetes mellitus in patients with arterial hypertension

The objective: the study of individual clinical demographic factors as the risk of chronic kidney disease (CKD) and diabetes mellitus (DM) in 93 patients esentsiynu arterial hypertension (EAH) in general medical practice.Patients and methods. Among the patients 49 (52.69%) men and 44 (47.31%) men, mean age 58,80 ± 9,60 years, disease duration from 4 to 25 years (average 15.2 ± 2 '68). At present 12 people with diabetes type 2 diabetes and CKD. All patients were complex research: general clinical, laboratory, instrumental and consult an ophthalmologist and neurologist.Results. It was established that obesity is a marker that increases the risk of DM in patients with EAH in 1,54 times [OR=2,63; OR 95% CI=0,73–9,44; p>0.05]. Body mass index ≤ 24,9 kg/m2, hyperglycemia and alanine aminotransferase elevation in blood (ALT >0,68 mmol/h*ml) cause the risk of CKD increase in 2,45 times [OR=3,18; OR 95% CI=0,82–12,37; p>0,05], 5 times [OR=25,0; OR 95% CI=2,92–213,9; p=0,001] and 3,37 times [OR=4,56; OR 95% CI=1,12–18,59; p=0,045], respectively. Increased body weight and obesity did not affect the risk of CKD in patients with EAH.Conclusion. The hypertension degrees are not associated with DM appearance in EAH patients, but EAH 3rd degree increases the CKD risk in 13,5 times [OR=16,0; OR 95% CI=1,33–192,8; p=0,043].

MP54-05 EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY AND THE RISK OF DIABETES MELLITUS: A POPULATION-BASED COHORT STUDY

You have accessJournal of UrologyStone Disease: Shock Wave Lithotripsy1 Apr 2016MP54-05 EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY AND THE RISK OF DIABETES MELLITUS: A POPULATION-BASED COHORT STUDY Michael Ordon, Blayne Welk, Jason Lee, R. D'A John Honey, and Kenneth Pace Michael OrdonMichael Ordon More articles by this author , Blayne WelkBlayne Welk More articles by this author , Jason LeeJason Lee More articles by this author , R. D'A John HoneyR. D'A John Honey More articles by this author , and Kenneth PaceKenneth Pace More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.575AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Our objective was to perform a population-based retrospective cohort study to determine if patients treated with shockwave lithotripsy (SWL) are at a greater risk for the development of diabetes mellitus (DM) than those treated with ureteroscopy (URS) METHODS All SWL and URS treatments performed in the province of Ontario between January 1994 and December 2012 were identified using linked administrative healthcare databases. The primary outcome was the development of DM > 90 days following treatment. SWL, the study exposure, was utilized as a time-dependent exposure to account for those who underwent SWL following URS. Unadjusted analysis with the Kaplan Meier method was used to examine the time to development of DM across the SWL and URS groups. Multivariable analysis with Cox proportional hazards regression was utilized to assess the risk for DM between SWL and URS groups while controlling for age, gender, region of residence, income quintile and comorbidity index. A sensitivity analysis was performed adjusting the time frame window for development of DM to a minimum of >180 and 365 days following treatment, respectively. RESULTS We identified 99,144 patients who underwent SWL or URS over the study period with a median follow-up of 6.6 years (SWL 8.5 years, URS 5.6 years). The groups had similar baseline characteristics (Table 1). Unadjusted survival analysis demonstrated an increased risk for the development of DM in the SWL group compared to the URS group (p<0.0008) (Figure 1). Similarly, multivariable analysis demonstrated an increased risk of DM in the SWL cohort (HR 1.08, 95% CI 1.04-1.12; p<0.0001). Sensitivity analysis revealed comparable results with an increased risk of DM in the SWL cohort both with the time for exclusion increased to 180 days (HR 1.08, 95% CI 1.04-1.12; p<0.0001) and 365 days (HR 1.09, 95% CI 1.05-1.13; p<0.0001). CONCLUSIONS Our population-based cohort study demonstrated a small, but significant increased risk of DM in patients undergoing SWL compared to URS. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e728 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Michael Ordon More articles by this author Blayne Welk More articles by this author Jason Lee More articles by this author R. D'A John Honey More articles by this author Kenneth Pace More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

PM370 Non-Invasive Molecular Ultrasound Imaging For Monitoring And Efficacy Testing Of Targeted Anti-Thrombotic Agents Using Platelet-Targeted Microbubbles

Introduction: Cardiovascular disease in patients with type 2 diabetes mellitus (DM) as a cause of death is a leader in virtually all countries of the world. The risk of coronary artery disease (CAD) in patients with type 2 DM is 2-4 times higher and the risk of acute myocardial infarction is 6-10 times higher than in the general population of patients. The condition of lipid profile and vascular inflammatory reaction is of great importance when shaping coronary atherosclerotic stenosis in patients with stable angina pectoris (SAP) and DM of type 2. Objectives: Comparable evaluation of lipid profile and inflammatory markers in patients with SAP and patients with SAP and DM of type 2. Methods: A total of 97 patients with CAD (mean age 60.3 9.8 years) with nonsignificant coronary stenosis (<75%) were examined. Group I included 33 patients with SAP and DM of type 2, group II consisted of 64 patients with SAP without DM. All patients received statins, ACE inhibitors, beta blockers, dual antiplatelet therapy. In group I all patients received antihyperglycemic therapy. Lipid profile parameters (total cholesterol, triglycerides, LDL cholesterol, VLDL cholesterol, lipoprotein (a), Apo-A, Apo-B), inflammatory markers (hs-CRP, TNF-alpha, homocysteine, interleukine 1 b, 6, 8, sCD40 L, MMP-9, TIMP-1), endothelial dysfunction markers (endothelin-1, nitrites) were measured. Results: There were high levels of hs-CRP, TNF-alpha, lipoprotein (a), MMP-9, triglycerides, and endothelin-1 in both groups. The level of TIMP-1 was significantly reduced in both groups. Patients in group 1 had significantly elevated levels of total cholesterol, LDL cholesterol, homocysteine, Apo-B, Apo-B/Apo A-1 ratio, IL -1 b . In group 1 the following positive correlations were found: between glycohemoglobin and Apo-B, Apo-B/Apo A-1 ratio, homocysteine, IL -1 b, sCD40 L; IL-6 and hs-CRP; homocysteine and LDL cholesterol, MMP-9, duration of CAD; endothelin-1 and sCD40L, TNF-alpha. It was shown that with an increase of 1 mmol/L in homocysteine level and of 1 mg/l in hs–CRP level, the risk of DM in patients with SAP increased by 1.1 and 3.8 times, respectively. Conclusion: In patients with type 2 DM there was a significant increase in the levels of atherogenic lipid fractions as well as homocysteine, hs-CRP and IL-1 b which may indicate a higher risk of coronary events even in the absence of significant coronary stenosis. Disclosure of Interest: None Declared