Pub Date : 2024-07-01DOI: 10.1016/j.dsx.2024.103094
Alina Pervez , Areesha Ahmer , Omar Mahmud , Russell Seth Martins , Hawra Hussain , Sameen Nasir , Sonia Pirzada , Mohsin Ali Mustafa , Uswah Siddiqi , Maheen Zakaria , Nashia Ali Rizvi , Ainan Arshad , Adil H. Haider , Sarah Nadeem
Background
Clinical practice guidelines (CPGs) are a helpful tool for the evidence-based management of Type 2 Diabetes Mellitus (T2D). The aim of this systematic review was to synthesize and appraise the scope and quality of South Asian T2D CPGs.
Methods
This PROPSERO registered (CRD42023425150) systematic review adhered to the 2020 PRISMA guidelines. We searched the PubMed, Embase, Cochrane, and Google Scholar databases for relevant guidelines. Data synthesis was performed using a qualitative approach and methodological quality was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool.
Results
We identified eleven unique CPGs (three each from Pakistan and Sri Lanka, two from India, and one each from Bangladesh, Nepal, and Bhutan) which were published or updated between 2017 and 2023. The CPGs included recommendations regarding screening, diagnosis, prevention, and management of T2D and its acute and chronic complications, comorbidities, and fasting with T2D. The AGREE II mean domain scores ranged from 37 % to 80 %; three CPGs were ‘recommended for clinical use,’ seven were ‘recommended for use with modifications’ and one was deemed unfit for implementation.
Conclusion
The present review summarized and appraised broadly CPGs from South Asia for T2D and can help direct improvements to future iterations.
{"title":"Clinical Practice Guidelines for the Management of Type 2 Diabetes in South Asia: A Systematic Review","authors":"Alina Pervez , Areesha Ahmer , Omar Mahmud , Russell Seth Martins , Hawra Hussain , Sameen Nasir , Sonia Pirzada , Mohsin Ali Mustafa , Uswah Siddiqi , Maheen Zakaria , Nashia Ali Rizvi , Ainan Arshad , Adil H. Haider , Sarah Nadeem","doi":"10.1016/j.dsx.2024.103094","DOIUrl":"10.1016/j.dsx.2024.103094","url":null,"abstract":"<div><h3>Background</h3><p>Clinical practice guidelines (CPGs) are a helpful tool for the evidence-based management of Type 2 Diabetes Mellitus (T2D). The aim of this systematic review was to synthesize and appraise the scope and quality of South Asian T2D CPGs.</p></div><div><h3>Methods</h3><p>This PROPSERO registered (CRD42023425150) systematic review adhered to the 2020 PRISMA guidelines. We searched the PubMed, Embase, Cochrane, and Google Scholar databases for relevant guidelines. Data synthesis was performed using a qualitative approach and methodological quality was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool.</p></div><div><h3>Results</h3><p>We identified eleven unique CPGs (three each from Pakistan and Sri Lanka, two from India, and one each from Bangladesh, Nepal, and Bhutan) which were published or updated between 2017 and 2023. The CPGs included recommendations regarding screening, diagnosis, prevention, and management of T2D and its acute and chronic complications, comorbidities, and fasting with T2D. The AGREE II mean domain scores ranged from 37 % to 80 %; three CPGs were ‘recommended for clinical use,’ seven were ‘recommended for use with modifications’ and one was deemed unfit for implementation.</p></div><div><h3>Conclusion</h3><p>The present review summarized and appraised broadly CPGs from South Asia for T2D and can help direct improvements to future iterations.</p></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 7","pages":"Article 103094"},"PeriodicalIF":4.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1016/j.dsx.2024.103095
Juan R. Ulloque-Badaracco , Ali Al-kassab-Córdova , Enrique A. Hernandez-Bustamante , Esteban A. Alarcon-Braga , Pamela Robles-Valcarcel , Miguel A. Huayta-Cortez , Juan C. Cabrera Guzmán , Rosa A. Seminario-Amez , Vicente A. Benites-Zapata
Background & aims
Asprosin is a promising candidate for novel treatments for metabolic–endocrine disorders. The objective of this systematic review and meta-analysis was to consolidate the existing evidence regarding asprosin levels in patients diagnosed with type 2 diabetes (T2D), metabolic syndrome (MetS), and obesity.
Methods
Scopus, Embase, PubMed, Ovid/Medline, and Web of Science were systematically searched without restrictions. We only used the standardized mean differences (SMD) with their 95 % confidence intervals (95 % CI) as the effect measure. A random-effects model (DerSimonian and Laird method) was used for the meta-analysis. Risk of bias was assessed with the Newcastle–Ottawa Scale and Newcastle–Ottawa Scale for Cross-Sectional Studies.
Results
Twenty-six studies (n = 3,787) were included in the meta-analysis. Participants with T2D had higher asprosin values than those without T2D (SMD: 1.64; 95 % CI: 1.08–2.21; I2 = 97 %). Patients with MetS had higher asprosin levels compared to those without MetS (SMD: 0.99; 95 % CI: 0.34–1.64; I2 = 96 %). Patients with obesity had higher asprosin levels than participants without obesity (SMD: 1.49; 95 % CI: 0.23–2.76; I2 = 98 %).
Conclusions
Asprosin is significantly higher in patients with either T2D, MetS, or obesity, compared with controls.
{"title":"Asprosin levels in patients with type 2 diabetes mellitus, metabolic syndrome and obesity: A systematic review and meta-analysis","authors":"Juan R. Ulloque-Badaracco , Ali Al-kassab-Córdova , Enrique A. Hernandez-Bustamante , Esteban A. Alarcon-Braga , Pamela Robles-Valcarcel , Miguel A. Huayta-Cortez , Juan C. Cabrera Guzmán , Rosa A. Seminario-Amez , Vicente A. Benites-Zapata","doi":"10.1016/j.dsx.2024.103095","DOIUrl":"10.1016/j.dsx.2024.103095","url":null,"abstract":"<div><h3>Background & aims</h3><p>Asprosin is a promising candidate for novel treatments for metabolic–endocrine disorders. The objective of this systematic review and meta-analysis was to consolidate the existing evidence regarding asprosin levels in patients diagnosed with type 2 diabetes (T2D), metabolic syndrome (MetS), and obesity.</p></div><div><h3>Methods</h3><p>Scopus, Embase, PubMed, Ovid/Medline, and Web of Science were systematically searched without restrictions. We only used the standardized mean differences (SMD) with their 95 % confidence intervals (95 % CI) as the effect measure. A random-effects model (DerSimonian and Laird method) was used for the meta-analysis. Risk of bias was assessed with the Newcastle–Ottawa Scale and Newcastle–Ottawa Scale for Cross-Sectional Studies.</p></div><div><h3>Results</h3><p>Twenty-six studies (n = 3,787) were included in the meta-analysis. Participants with T2D had higher asprosin values than those without T2D (SMD: 1.64; 95 % CI: 1.08–2.21; I<sup>2</sup> = 97 %). Patients with MetS had higher asprosin levels compared to those without MetS (SMD: 0.99; 95 % CI: 0.34–1.64; I<sup>2</sup> = 96 %). Patients with obesity had higher asprosin levels than participants without obesity (SMD: 1.49; 95 % CI: 0.23–2.76; I<sup>2</sup> = 98 %).</p></div><div><h3>Conclusions</h3><p>Asprosin is significantly higher in patients with either T2D, MetS, or obesity, compared with controls.</p></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 7","pages":"Article 103095"},"PeriodicalIF":4.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.dsx.2024.103048
Wen Sun , Xiaoyu Zhang , Ning Li , Yan He , Jianguang Ji , Deqiang Zheng
Aims
To evaluate the potential causal effect of glycemic traits on lung cancer and investigate the impact of antihyperglycemic agent-target genes on lung cancer risk.
Methods
Genetic variants associated with glycemic traits, antihyperglycemic agent-target genes, and lung cancer were extracted from the Meta-Analyses of Glucose and Insulin-related traits Consortium (MAGIC), expression quantitative trait loci (eQTLs), protein quantitative trait loci (pQTLs), and the International Lung Cancer Consortium (ILCCO), respectively. Mendelian randomization (MR) analyses were performed to examine the associations of glycemic traits and antihyperglycemic agent-target genes with lung cancer. Mediation analysis was conducted to explore whether overweight operated as a mediator between antihyperglycemic agents and lung cancer outcomes.
Results
Genetically determined glycated hemoglobin A1c levels were associated with squamous cell lung cancer (OR = 1.78; 95 % CI, 1.08–2.92; p = 0.023). The PRKAB1 gene (the target of metformin) was associated with a lower risk of developing lung adenocarcinoma (OR = 0.85; 95 % CI, 0.76–0.96; p = 0.006). Further mediation analyses did not support overweight as a mediator between PRKAB1 activation and lung adenocarcinoma.
Conclusion
Our analyses suggest an association of genetically determined abnormal glycemic traits with squamous cell lung cancer. The potential association between PRKAB1 activation and a reduced risk of developing lung adenocarcinoma appears to be independent of the anti-obesity effects of metformin, suggesting that PRKAB1 activation may have a direct protective effect on lung adenocarcinoma development.
{"title":"Genetic association of glycemic traits and antihyperglycemic agent target genes with the risk of lung cancer: A Mendelian randomization study","authors":"Wen Sun , Xiaoyu Zhang , Ning Li , Yan He , Jianguang Ji , Deqiang Zheng","doi":"10.1016/j.dsx.2024.103048","DOIUrl":"10.1016/j.dsx.2024.103048","url":null,"abstract":"<div><h3>Aims</h3><p>To evaluate the potential causal effect of glycemic traits on lung cancer and investigate the impact of antihyperglycemic agent-target genes on lung cancer risk.</p></div><div><h3>Methods</h3><p>Genetic variants associated with glycemic traits, antihyperglycemic agent-target genes, and lung cancer were extracted from the Meta-Analyses of Glucose and Insulin-related traits Consortium (MAGIC), expression quantitative trait loci (eQTLs), protein quantitative trait loci (pQTLs), and the International Lung Cancer Consortium (ILCCO), respectively. Mendelian randomization (MR) analyses were performed to examine the associations of glycemic traits and antihyperglycemic agent-target genes with lung cancer. Mediation analysis was conducted to explore whether overweight operated as a mediator between antihyperglycemic agents and lung cancer outcomes.</p></div><div><h3>Results</h3><p>Genetically determined glycated hemoglobin A1c levels were associated with squamous cell lung cancer (OR = 1.78; 95 % CI, 1.08–2.92; <em>p</em> = 0.023). The <em>PRKAB1</em> gene (the target of metformin) was associated with a lower risk of developing lung adenocarcinoma (OR = 0.85; 95 % CI, 0.76–0.96; <em>p</em> = 0.006). Further mediation analyses did not support overweight as a mediator between <em>PRKAB1</em> activation and lung adenocarcinoma.</p></div><div><h3>Conclusion</h3><p>Our analyses suggest an association of genetically determined abnormal glycemic traits with squamous cell lung cancer. The potential association between <em>PRKAB1</em> activation and a reduced risk of developing lung adenocarcinoma appears to be independent of the anti-obesity effects of metformin, suggesting that <em>PRKAB1</em> activation may have a direct protective effect on lung adenocarcinoma development.</p></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 6","pages":"Article 103048"},"PeriodicalIF":10.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141281776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.dsx.2024.103065
Pedram Pam , Iman El Sayed , Sanaz Asemani , Parsa Jamilian , Meysam Zarezadeh , Zohreh Ghoreishy
Aims
This systematic review and meta-analysis aims to evaluate the effectiveness of chia seeds in improving glycemic status, including fasting blood glucose (FBG), glycated hemoglobin (HbA1c), and insulin.
Methods
A comprehensive literature search was conducted on PubMed, Scopus, Web of Science, Cochrane, and Google Scholar up to January 2024. Randomized controlled trials (RCTs) assessing the effect of chia seeds on FBG, HbA1c, and/or insulin that meet our eligibility criteria were included. Version 2 of the Cochrane risk-of-bias tool (RoB2) was used to assess the quality of the included studies. Data were extracted and analyzed using a random-effects model and reported as weighted mean differences (WMD) with 95 % confidence intervals (CI). Subgroup and sensitivity analyses were also performed. The registration number was CRD42023441766.
Results
Out of 341 articles retrieved from the initial search, 8 RCTs (with 10 arms) involving 362 participants were included in the meta-analysis. The results showed that chia consumption had no significant effect on FBG (WMD: 0.79 %; 95 % CI: −0.97 to 2.55; p = 0.38), HbA1c (WMD: −0.12 %; 95 % CI: −0.27 to 0.02; p = 0.09), and insulin (WMD:1.23 %; 95 % CI: −1.77 to 4.22; p = 0.42).
Conclusions
Chia seed consumption shows no significant impact on FBG, HbA1c, and insulin levels. This study is limited by the small number of studies in the meta-analysis and the significant heterogeneity among them, necessitating further research with larger sample sizes.
{"title":"The effectiveness of chia seed in improving glycemic status: A systematic review and meta-analysis","authors":"Pedram Pam , Iman El Sayed , Sanaz Asemani , Parsa Jamilian , Meysam Zarezadeh , Zohreh Ghoreishy","doi":"10.1016/j.dsx.2024.103065","DOIUrl":"10.1016/j.dsx.2024.103065","url":null,"abstract":"<div><h3>Aims</h3><p>This systematic review and meta-analysis aims to evaluate the effectiveness of chia seeds in improving glycemic status, including fasting blood glucose (FBG), glycated hemoglobin (HbA1c), and insulin.</p></div><div><h3>Methods</h3><p>A comprehensive literature search was conducted on PubMed, Scopus, Web of Science, Cochrane, and Google Scholar up to January 2024. Randomized controlled trials (RCTs) assessing the effect of chia seeds on FBG, HbA1c, and/or insulin that meet our eligibility criteria were included. Version 2 of the Cochrane risk-of-bias tool (RoB2) was used to assess the quality of the included studies. Data were extracted and analyzed using a random-effects model and reported as weighted mean differences (WMD) with 95 % confidence intervals (CI). Subgroup and sensitivity analyses were also performed. The registration number was <strong>CRD42023441766</strong>.</p></div><div><h3>Results</h3><p>Out of 341 articles retrieved from the initial search, 8 RCTs (with 10 arms) involving 362 participants were included in the meta-analysis. The results showed that chia consumption had no significant effect on FBG (WMD: 0.79 %; 95 % CI: −0.97 to 2.55; <em>p</em> = 0.38), HbA1c (WMD: −0.12 %; 95 % CI: −0.27 to 0.02; <em>p</em> = 0.09), and insulin (WMD:1.23 %; 95 % CI: −1.77 to 4.22; <em>p</em> = 0.42).</p></div><div><h3>Conclusions</h3><p>Chia seed consumption shows no significant impact on FBG, HbA1c, and insulin levels. This study is limited by the small number of studies in the meta-analysis and the significant heterogeneity among them, necessitating further research with larger sample sizes.</p></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 6","pages":"Article 103065"},"PeriodicalIF":4.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141451908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.dsx.2024.103066
Hanzhang Wu , Jiahe Wei , Shuai Wang , Wenjuan Chen , Liangkai Chen , Jihui Zhang , Ningjian Wang , Xiao Tan
Background
The association of cardiovascular health levels, as measured by the Life's Essential 8 score, with cardiovascular disease (CVD) incidence and mortality among individuals with type 2 diabetes (T2D) has not been fully elucidated.
Methods
This cohort study included 15,118 participants with T2D from the UK Biobank who were free of CVD and cancer at baseline. The cardiovascular health of participants was evaluated using the Life's Essential 8 score, categorizing their health levels into low, moderate, and high based on this assessment.
Results
During a median follow-up period of 13.0 years, we observed a total of 4421 cases of CVD, comprising 3467 cases of coronary heart disease (CHD), 811 cases of stroke, 1465 cases of heart failure (HF), and 523 cases of CVD mortality. Compared to participants with low cardiovascular health, those with high cardiovascular health had a 52 %, 50 %, 47 %, 67 %, and 51 % lower risk of CVD, CHD, stroke, HF, and CVD mortality, respectively. Among the components of the Life's Essential 8 score, body mass index showed the highest population attributable risk of 12.1 %. Similar findings were observed in joint analyses of cardiovascular health and diabetes severity status.
Conclusions
This study emphasizes the importance of maintaining good cardiovascular health among individuals with T2D to reduce their risk of CVD incidence and mortality.
{"title":"Life's Essential 8 and risks of cardiovascular morbidity and mortality among individuals with type 2 diabetes: A cohort study","authors":"Hanzhang Wu , Jiahe Wei , Shuai Wang , Wenjuan Chen , Liangkai Chen , Jihui Zhang , Ningjian Wang , Xiao Tan","doi":"10.1016/j.dsx.2024.103066","DOIUrl":"10.1016/j.dsx.2024.103066","url":null,"abstract":"<div><h3>Background</h3><p>The association of cardiovascular health levels, as measured by the Life's Essential 8 score, with cardiovascular disease (CVD) incidence and mortality among individuals with type 2 diabetes (T2D) has not been fully elucidated.</p></div><div><h3>Methods</h3><p>This cohort study included 15,118 participants with T2D from the UK Biobank who were free of CVD and cancer at baseline. The cardiovascular health of participants was evaluated using the Life's Essential 8 score, categorizing their health levels into low, moderate, and high based on this assessment.</p></div><div><h3>Results</h3><p>During a median follow-up period of 13.0 years, we observed a total of 4421 cases of CVD, comprising 3467 cases of coronary heart disease (CHD), 811 cases of stroke, 1465 cases of heart failure (HF), and 523 cases of CVD mortality. Compared to participants with low cardiovascular health, those with high cardiovascular health had a 52 %, 50 %, 47 %, 67 %, and 51 % lower risk of CVD, CHD, stroke, HF, and CVD mortality, respectively. Among the components of the Life's Essential 8 score, body mass index showed the highest population attributable risk of 12.1 %. Similar findings were observed in joint analyses of cardiovascular health and diabetes severity status.</p></div><div><h3>Conclusions</h3><p>This study emphasizes the importance of maintaining good cardiovascular health among individuals with T2D to reduce their risk of CVD incidence and mortality.</p></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 6","pages":"Article 103066"},"PeriodicalIF":4.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.dsx.2024.103043
Ruixuan Chen , Sheng Nie , Shiyu Zhou , Licong Su , Yanqin Li , Xiaodong Zhang , Fan Luo , Ruqi Xu , Qi Gao , Yuxin Lin , Zhixin Guo , Lisha Cao , Xin Xu
Aims
To assess the relationships between urate-lowering therapy (ULT) initiation with all-cause mortality in patients with asymptomatic hyperuricemia and Type 2 Diabetes (T2D).
Methods
This nationwide retrospective cohort study involved patients with T2D and asymptomatic hyperuricemia from 19 academic hospitals across China between 2000 and 2021. The primary exposure was ULT initiation, including allopurinol, febuxostat, or benzbromarone. The primary outcome was all-cause mortality. The secondary outcomes were cardiovascular (CV) and non-CV mortality. Propensity score matching was employed to create a 1:2 matched cohort with balanced likelihood of ULT initiation. Associations between ULT initiation with all-cause and CV mortality were assessed in the matched cohort.
Results
Among 42 507 patients, 5028 initiated ULT and 37 479 did not. In the matched cohort, comprising 4871 ULT initiators and 9047 noninitiators, ULT initiation was significantly associated with reduced risk of all-cause mortality (hazard ratio [HR] 0.77; 95% confidence interval [CI], 0.71–0.84), CV mortality (HR 0.86; 95% CI, 0.76–0.97), and non-CV mortality (HR 0.72; 95% CI, 0.64–0.80) over an average 3.0 years of follow-up. Among the ULT initiators, post-treatment SUA levels of 360–420 μmol/L was related to a significantly lower risk for all-cause mortality compared to levels >420 μmol/L (HR 0.74; 95% CI, 0.59–0.94) while levels ≤360 μmol/L did not (HR, 0.96; 95% CI, 0.81–1.14), suggesting a U-shaped relationship.
Conclusions
Initiating ULT was associated with a significant reduction in all-cause mortality in patients with T2D and asymptomatic hyperuricemia. Notably, maintaining post-treatment SUA concentrations within 360–420 μmol/L could potentially enhance this reduced mortality.
{"title":"Association between urate-lowering therapy initiation and all-cause mortality in patients with type 2 diabetes and asymptomatic hyperuricemia","authors":"Ruixuan Chen , Sheng Nie , Shiyu Zhou , Licong Su , Yanqin Li , Xiaodong Zhang , Fan Luo , Ruqi Xu , Qi Gao , Yuxin Lin , Zhixin Guo , Lisha Cao , Xin Xu","doi":"10.1016/j.dsx.2024.103043","DOIUrl":"10.1016/j.dsx.2024.103043","url":null,"abstract":"<div><h3>Aims</h3><p>To assess the relationships between urate-lowering therapy (ULT) initiation with all-cause mortality in patients with asymptomatic hyperuricemia and Type 2 Diabetes (T2D).</p></div><div><h3>Methods</h3><p>This nationwide retrospective cohort study involved patients with T2D and asymptomatic hyperuricemia from 19 academic hospitals across China between 2000 and 2021. The primary exposure was ULT initiation, including allopurinol, febuxostat, or benzbromarone. The primary outcome was all-cause mortality. The secondary outcomes were cardiovascular (CV) and non-CV mortality. Propensity score matching was employed to create a 1:2 matched cohort with balanced likelihood of ULT initiation. Associations between ULT initiation with all-cause and CV mortality were assessed in the matched cohort.</p></div><div><h3>Results</h3><p>Among 42 507 patients, 5028 initiated ULT and 37 479 did not. In the matched cohort, comprising 4871 ULT initiators and 9047 noninitiators, ULT initiation was significantly associated with reduced risk of all-cause mortality (hazard ratio [HR] 0.77; 95% confidence interval [CI], 0.71–0.84), CV mortality (HR 0.86; 95% CI, 0.76–0.97), and non-CV mortality (HR 0.72; 95% CI, 0.64–0.80) over an average 3.0 years of follow-up. Among the ULT initiators, post-treatment SUA levels of 360–420 μmol/L was related to a significantly lower risk for all-cause mortality compared to levels >420 μmol/L (HR 0.74; 95% CI, 0.59–0.94) while levels ≤360 μmol/L did not (HR, 0.96; 95% CI, 0.81–1.14), suggesting a U-shaped relationship.</p></div><div><h3>Conclusions</h3><p>Initiating ULT was associated with a significant reduction in all-cause mortality in patients with T2D and asymptomatic hyperuricemia. Notably, maintaining post-treatment SUA concentrations within 360–420 μmol/L could potentially enhance this reduced mortality.</p></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 6","pages":"Article 103043"},"PeriodicalIF":4.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141131877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.dsx.2024.103067
Hong-Da Zhang , Lei Ding , Ke Liu , Li-Jie Mi , Ai-Kai Zhang , Feng-Yuan Yu , Xin-Xin Yan , Fu-Hua Peng , Yu-Jing Shen , Min Tang
Background
Semaglutide, a glucagon-like peptide-1 receptor agonist, is reported to have cardiac benefits, but its effects on preventing atrial fibrillation (AF) remain inconclusive. This study aimed to investigate whether semaglutide can prevent AF occurrence in patients with type 2 diabetes mellitus (T2DM), obesity, or overweight.
Methods
We searched MEDLINE, EMBASE, the Cochrane CENTRAL database, and clinicaltrials.gov from inception to December 29, 2023. Randomized controlled trials of semaglutide in patients with T2DM, obesity, or overweight were included. The primary outcome was AF occurrence. Relative risks (RRs) with 95 % confidence intervals (CIs) were calculated for the overall population and subgroups.
Results
Twenty-one trials comprising 25957 patients were included. In the overall pooled analysis, semaglutide decreased AF occurrence compared to control drugs (RR 0.70, 95 % CI 0.52–0.95). This result was consistent in trials using other antihyperglycemic medications as controls (RR 0.43, 95 % CI 0.21–0.89), but not in placebo-controlled trials (RR 0.77, 95 % CI 0.56–1.07). The outcome was favorable for patients with T2DM (RR 0.71, 95 % CI 0.52–0.97), but not for patients with overweight or obesity (RR 0.56, 95 % CI 0.18–1.73). Results varied by type of semaglutide, with oral semaglutide showing an RR of 0.49 (95 % CI 0.25–0.97) and subcutaneous semaglutide showing an RR of 0.77 (95 % CI 0.55–1.07).
Conclusion
Semaglutide was associated with a reduced risk of AF occurrence in the overall analysis. Favorable outcomes were observed in subsets using other antihyperglycemic medications as controls, in patients with T2DM, and with oral semaglutide.
背景据报道，胰高血糖素样肽-1受体激动剂塞马鲁肽对心脏有益，但其预防心房颤动（房颤）的效果仍无定论。本研究旨在探讨semaglutide能否预防2型糖尿病（T2DM）、肥胖或超重患者的房颤发生。方法我们检索了MEDLINE、EMBASE、Cochrane CENTRAL数据库和clinicaltrials.gov从开始到2023年12月29日的资料。纳入了针对 T2DM、肥胖或超重患者的塞马鲁肽随机对照试验。主要结果为房颤发生率。结果纳入了21项试验，共25957名患者。在总体汇总分析中，与对照药物相比，舍马鲁肽可降低房颤发生率（RR 0.70，95 % CI 0.52-0.95）。这一结果在使用其他降糖药物作为对照的试验中是一致的（RR 0.43，95 % CI 0.21-0.89），但在安慰剂对照试验中却不一致（RR 0.77，95 % CI 0.56-1.07）。这一结果对 T2DM 患者有利（RR 0.71，95 % CI 0.52-0.97），但对超重或肥胖患者不利（RR 0.56，95 % CI 0.18-1.73）。结果因塞马鲁肽的类型而异，口服塞马鲁肽的RR为0.49（95 % CI 0.25-0.97），皮下注射塞马鲁肽的RR为0.77（95 % CI 0.55-1.07）。在使用其他降糖药物作为对照的亚组、T2DM 患者以及口服舍马鲁肽的患者中，均观察到了有利的结果。
{"title":"Semaglutide for the prevention of atrial fibrillation: A systematic review and meta-analysis","authors":"Hong-Da Zhang , Lei Ding , Ke Liu , Li-Jie Mi , Ai-Kai Zhang , Feng-Yuan Yu , Xin-Xin Yan , Fu-Hua Peng , Yu-Jing Shen , Min Tang","doi":"10.1016/j.dsx.2024.103067","DOIUrl":"https://doi.org/10.1016/j.dsx.2024.103067","url":null,"abstract":"<div><h3>Background</h3><p>Semaglutide, a glucagon-like peptide-1 receptor agonist, is reported to have cardiac benefits, but its effects on preventing atrial fibrillation (AF) remain inconclusive. This study aimed to investigate whether semaglutide can prevent AF occurrence in patients with type 2 diabetes mellitus (T2DM), obesity, or overweight.</p></div><div><h3>Methods</h3><p>We searched MEDLINE, EMBASE, the Cochrane CENTRAL database, and clinicaltrials.gov from inception to December 29, 2023. Randomized controlled trials of semaglutide in patients with T2DM, obesity, or overweight were included. The primary outcome was AF occurrence. Relative risks (RRs) with 95 % confidence intervals (CIs) were calculated for the overall population and subgroups.</p></div><div><h3>Results</h3><p>Twenty-one trials comprising 25957 patients were included. In the overall pooled analysis, semaglutide decreased AF occurrence compared to control drugs (RR 0.70, 95 % CI 0.52–0.95). This result was consistent in trials using other antihyperglycemic medications as controls (RR 0.43, 95 % CI 0.21–0.89), but not in placebo-controlled trials (RR 0.77, 95 % CI 0.56–1.07). The outcome was favorable for patients with T2DM (RR 0.71, 95 % CI 0.52–0.97), but not for patients with overweight or obesity (RR 0.56, 95 % CI 0.18–1.73). Results varied by type of semaglutide, with oral semaglutide showing an RR of 0.49 (95 % CI 0.25–0.97) and subcutaneous semaglutide showing an RR of 0.77 (95 % CI 0.55–1.07).</p></div><div><h3>Conclusion</h3><p>Semaglutide was associated with a reduced risk of AF occurrence in the overall analysis. Favorable outcomes were observed in subsets using other antihyperglycemic medications as controls, in patients with T2DM, and with oral semaglutide.</p></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 6","pages":"Article 103067"},"PeriodicalIF":4.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141480292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.dsx.2024.103072
Mohamed Elamin , Maxwell S. Barnish
Aims
To systematically review evidence on the effect of fixed-ratio combinations on adherence in people with type 2 diabetes.
Methods
Systematic searches were conducted using MEDLINE and EMBASE in March 2023. Standardised screening, data extraction and risk of bias assessment were conducted. All review procedures were conducted independently by two reviewers. Eligible studies assessed the effect of fixed-ratio combinations on adherence in people with type 2 diabetes. Narrative synthesis was conducted to analyse findings.
Results
A total of 488 records were identified, of which 37 proceeded to full-text screening and 7 – each representing a unique study – were included in the systematic review. Among the included studies, 3 were randomised controlled trials and 4 were cohort studies. Following narrative synthesis, it was shown that fixed-ratio combinations improved patient satisfaction and treatment adherence.
Conclusions
Available evidence supports a benefit for fixed-ratio combinations on patient satisfaction and treatment adherence in people with type 2 diabetes.
{"title":"Effect of fixed-ratio insulin combinations on adherence in type 2 diabetes: Systematic review","authors":"Mohamed Elamin , Maxwell S. Barnish","doi":"10.1016/j.dsx.2024.103072","DOIUrl":"10.1016/j.dsx.2024.103072","url":null,"abstract":"<div><h3>Aims</h3><p>To systematically review evidence on the effect of fixed-ratio combinations on adherence in people with type 2 diabetes.</p></div><div><h3>Methods</h3><p>Systematic searches were conducted using MEDLINE and EMBASE in March 2023. Standardised screening, data extraction and risk of bias assessment were conducted. All review procedures were conducted independently by two reviewers. Eligible studies assessed the effect of fixed-ratio combinations on adherence in people with type 2 diabetes. Narrative synthesis was conducted to analyse findings.</p></div><div><h3>Results</h3><p>A total of 488 records were identified, of which 37 proceeded to full-text screening and 7 – each representing a unique study – were included in the systematic review. Among the included studies, 3 were randomised controlled trials and 4 were cohort studies. Following narrative synthesis, it was shown that fixed-ratio combinations improved patient satisfaction and treatment adherence.</p></div><div><h3>Conclusions</h3><p>Available evidence supports a benefit for fixed-ratio combinations on patient satisfaction and treatment adherence in people with type 2 diabetes.</p></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 6","pages":"Article 103072"},"PeriodicalIF":4.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1871402124001334/pdfft?md5=7701ca61dd31693a44417017e476bbc0&pid=1-s2.0-S1871402124001334-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141623140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.dsx.2024.103049
Robel Hussen Kabthymer , Md Nazmul Karim , Catherine Itsiopoulos , Allison M. Hodge , Barbora De Courten
Aims
We aimed to assess the association of a low carbohydrate diet score (LCD) with the incidence of type 2 diabetes (T2D) using Melbourne Collaborative Cohort Study (MCCS) data.
Methods
Between 1990 and 1994, the MCCS recruited 41,513 people aged 40–69 years. The first and second follow-ups were conducted in 1995–1998 and 2003–2007, respectively. We analyzed data from 39,185 participants. LCD score was calculated at baseline as the percentage of energy from carbohydrate, fat, and protein. The higher the score the less percentage of carbohydrates contributed to energy intake. The association of LCD quintiles with the incidence of diabetes was assessed using modified Poisson regression, adjusted for lifestyle, obesity, socioeconomic and other confounders. Mediation of the association by adiposity (BMI) was assessed.
Results
LCD was positively associated with diabetes risk. Higher LCD score (p for trend = 0.001) was associated with increased risk of T2D. Quintile 5 (38 % energy from carbohydrates) versus quintile 1 (55 % energy from carbohydrates) showed a 20 % increased diabetes risk (incidence risk ratio (IRR) = 1.20 (95 % CI: 1.05–1.37)). A further adjustment for BMI (Body Mass Index) and WHR (Waist-to-Hip-Ratio) eliminated the association. Mediation analysis demonstrated that BMI mediated 76 % of the LCD & diabetes association.
Conclusions
Consuming a low carbohydrate diet, reflected as a high LCD score, may increase the risk of T2D which is largely explained by obesity. Results highlight the need for further studies, including clinical trials investigating the effects of a low carbohydrate diet in T2D.
{"title":"Association of low carbohydrate diet score with the risk of type 2 diabetes in an Australian population: A longitudinal study","authors":"Robel Hussen Kabthymer , Md Nazmul Karim , Catherine Itsiopoulos , Allison M. Hodge , Barbora De Courten","doi":"10.1016/j.dsx.2024.103049","DOIUrl":"https://doi.org/10.1016/j.dsx.2024.103049","url":null,"abstract":"<div><h3>Aims</h3><p>We aimed to assess the association of a low carbohydrate diet score (LCD) with the incidence of type 2 diabetes (T2D) using Melbourne Collaborative Cohort Study (MCCS) data.</p></div><div><h3>Methods</h3><p>Between 1990 and 1994, the MCCS recruited 41,513 people aged 40–69 years. The first and second follow-ups were conducted in 1995–1998 and 2003–2007, respectively. We analyzed data from 39,185 participants. LCD score was calculated at baseline as the percentage of energy from carbohydrate, fat, and protein. The higher the score the less percentage of carbohydrates contributed to energy intake. The association of LCD quintiles with the incidence of diabetes was assessed using modified Poisson regression, adjusted for lifestyle, obesity, socioeconomic and other confounders. Mediation of the association by adiposity (BMI) was assessed.</p></div><div><h3>Results</h3><p>LCD was positively associated with diabetes risk. Higher LCD score (p for trend = 0.001) was associated with increased risk of T2D. Quintile 5 (38 % energy from carbohydrates) versus quintile 1 (55 % energy from carbohydrates) showed a 20 % increased diabetes risk (incidence risk ratio (IRR) = 1.20 (95 % CI: 1.05–1.37)). A further adjustment for BMI (Body Mass Index) and WHR (Waist-to-Hip-Ratio) eliminated the association. Mediation analysis demonstrated that BMI mediated 76 % of the LCD & diabetes association.</p></div><div><h3>Conclusions</h3><p>Consuming a low carbohydrate diet, reflected as a high LCD score, may increase the risk of T2D which is largely explained by obesity. Results highlight the need for further studies, including clinical trials investigating the effects of a low carbohydrate diet in T2D.</p></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 6","pages":"Article 103049"},"PeriodicalIF":10.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1871402124001103/pdfft?md5=f6e18ba59ea86e7fcb9ba655d0d678bd&pid=1-s2.0-S1871402124001103-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141244405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To evaluate burden of postpartum diabetes and other cardiometabolic risk factors among women who test positive for gestational diabetes mellitus (GDM) by International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria, but negative by alternate criteria.
Methods
This prospective cross-sectional study was conducted from 2019 to 2022 and is a sub-study of the CHIP–F cohort (Cohort Study of Indian Women with Hyperglycemia in Pregnancy and their Families).
Results
Study participants (n = 826; 183 with normoglycemia and 643 with GDM using IADPSG criteria) were evaluated at a median (IQR) postpartum interval of 31 (21–45) months. Using the United Kingdom National Institute of Health and Care Excellence (UK NICE), Canadian Diabetes Association (CDA), and Diabetes in Pregnancy Study Group India (DIPSI) criteria, 251 (39.0 %), 148 (23.0 %) and 384 (59.7 %) women who tested positive for GDM by IADPSG criteria, would have tested negative. The incidence of postpartum diabetes among such women was 30.4, 34.3, and 48.2 per 1000 women-years, respectively, which was significantly higher than those testing negative by both IADPSG and UK NICE (5.0 per 1000 women-years), IADPSG and CDA (9.2/1000 women-years) and IADPSG and DIPSI criteria (5.0/1000 women-years). The burden of obesity and metabolic syndrome was also significantly higher in such women.
Conclusions
We found a significant burden of postpartum diabetes and cardiometabolic risk factors among women who tested positive for GDM by IADPSG, but negative by alternate criteria. There are potential clinical implications of a “failed” diagnosis for future cardiometabolic diseases that need to be carefully examined.
{"title":"Postpartum glycemic and cardiometabolic profile of women testing positive for gestational diabetes mellitus by International Association of Diabetes and Pregnancy Study Groups (IADPSG) but negative by alternate criteria: Insights from CHIP–F study","authors":"Yashdeep Gupta , Alpesh Goyal , Samita Ambekar , Mani Kalaivani , Neerja Bhatla , Nikhil Tandon","doi":"10.1016/j.dsx.2024.103064","DOIUrl":"10.1016/j.dsx.2024.103064","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate burden of postpartum diabetes and other cardiometabolic risk factors among women who test positive for gestational diabetes mellitus (GDM) by International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria, but negative by alternate criteria.</p></div><div><h3>Methods</h3><p>This prospective cross-sectional study was conducted from 2019 to 2022 and is a sub-study of the CHIP–F cohort (Cohort Study of Indian Women with Hyperglycemia in Pregnancy and their Families).</p></div><div><h3>Results</h3><p>Study participants (n = 826; 183 with normoglycemia and 643 with GDM using IADPSG criteria) were evaluated at a median (IQR) postpartum interval of 31 (21–45) months. Using the United Kingdom National Institute of Health and Care Excellence (UK NICE), Canadian Diabetes Association (CDA), and Diabetes in Pregnancy Study Group India (DIPSI) criteria, 251 (39.0 %), 148 (23.0 %) and 384 (59.7 %) women who tested positive for GDM by IADPSG criteria, would have tested negative. The incidence of postpartum diabetes among such women was 30.4, 34.3, and 48.2 per 1000 women-years, respectively, which was significantly higher than those testing negative by both IADPSG and UK NICE (5.0 per 1000 women-years), IADPSG and CDA (9.2/1000 women-years) and IADPSG and DIPSI criteria (5.0/1000 women-years). The burden of obesity and metabolic syndrome was also significantly higher in such women.</p></div><div><h3>Conclusions</h3><p>We found a significant burden of postpartum diabetes and cardiometabolic risk factors among women who tested positive for GDM by IADPSG, but negative by alternate criteria. There are potential clinical implications of a “failed” diagnosis for future cardiometabolic diseases that need to be carefully examined.</p></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"18 6","pages":"Article 103064"},"PeriodicalIF":4.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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