Diabetes & metabolism最新文献

{"title":"Association between fatty liver index and risk of end-stage renal disease stratified by kidney function in patients with type 2 diabetes: A nationwide population-based study","authors":"Goh Eun Chung ,&nbsp;Kyungdo Han ,&nbsp;Kyu-Na Lee ,&nbsp;Jung Ho Bae ,&nbsp;Sun Young Yang ,&nbsp;Su-Yeon Choi ,&nbsp;Jeong Yoon Yim ,&nbsp;Nam Ju Heo","doi":"10.1016/j.diabet.2023.101454","DOIUrl":"10.1016/j.diabet.2023.101454","url":null,"abstract":"<div><h3>Objective</h3><p>The effects of nonalcoholic fatty liver disease on the risk of end-stage renal disease (ESRD) remain unclear. We investigated the association between the fatty liver index (FLI) and risk of ESRD in patients with type 2 diabetes.</p></div><div><h3>Methods</h3><p>This population‐based observational cohort study enrolled patients with diabetes who underwent health screening between 2009 and 2012 and utilized data from the Korean National Health Insurance Services. The FLI functioned as a surrogate marker for the presence of hepatic steatosis. Chronic kidney disease (CKD) was defined as an estimated glomerular filtration rate &lt; 60 ml/min/1.73 m² calculated using the Modification of Diet in Renal Disease equation. We performed Cox proportional hazards regression.</p></div><div><h3>Results</h3><p>Incident ESRD developed in 19,476 of 1,900,598 patients with type 2 diabetes during a median follow-up of 7.2 years. After adjusting for conventional risk factors, patients with high FLI scores had a higher risk for ESRD: FLI, 30–59 [hazard ratio (HR) = 1.124; 95% confidence interval (CI), 1.083–1.166]; FLI ≥ 60 [HR = 1.278; 95% CI, 1.217–1.343] compared with those with FLI &lt; 30. The association between a high FLI score (≥ 60) and incident ESRD was more prominent in women than in men (male, FLI ≥60: HR, 1.106; 95% CI = 1.041–1.176 and female, FLI ≥ 60: HR, 1.835; 95% CI = 1.689–1.995). The association between a high FLI score (≥ 60) and the risk of ESRD differed according to baseline kidney function. High FLI scores increased the risk of ESRD (HR = 1.268; 95% CI, 1.198–1.342) in patients with CKD at baseline.</p></div><div><h3>Conclusion</h3><p>High FLI scores are associated with a greater risk of ESRD in patients with type 2 diabetes with CKD at baseline. Close monitoring and appropriate management of hepatic steatosis may aid in preventing the progression of kidney dysfunction in patients with type 2 diabetes and CKD.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9785416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of women with mild gestational diabetes mellitus decreases the risk of adverse perinatal outcomes","authors":"Fanny Goyette ,&nbsp;Bi Lan Wo ,&nbsp;Marie-Hélène Iglesias ,&nbsp;Evelyne Rey ,&nbsp;Ariane Godbout","doi":"10.1016/j.diabet.2023.101458","DOIUrl":"10.1016/j.diabet.2023.101458","url":null,"abstract":"<div><h3>Aims</h3><p>Glycemic thresholds used to diagnose gestational diabetes mellitus (GDM) are a continued subject of debate. Lower glycemic thresholds identify women with milder GDM for whom treatment benefit is unclear. We compared adverse maternal and neonatal outcomes in treated and untreated women with mild hyperglycemia.</p></div><div><h3>Methods</h3><p>We reviewed 11 553 patient charts from two tertiary care centers and included singleton pregnancies &gt;32-week gestation. GDM was diagnosed using the one- or two-step 75 g oral glucose tolerance test (OGTT) depending on the center. All OGTT results were reviewed. Women with glycemic values falling between the thresholds of the two tests, referred to as intermediate hyperglycemic (IH), defined as FPG 5.1–5.2 mmol/L, 1 h PG 10.0–10.5 mmol/L, or 2 h PG 8.5–8.9 mmol/L at 75 g OGTT, were untreated at center A and treated at center B.</p></div><div><h3>Results</h3><p>There were 630 women with IH, 334 were untreated (center A) and 296 who were treated (center B). After adjusting for covariates, untreated IH women had significantly higher rates of gestational hypertension (aOR 6.02, <em>P</em> = 0.002), large for gestational age (LGA) (aOR 3.73, <em>P</em> &lt; 0.001) and birthweights &gt; 4000 g (aOR 3.35, <em>P</em> = 0.001). Our results indicate that treating 11 women with IH would prevent one LGA birth and treating 13 would prevent 1 birthweight &gt; 4000 g.</p></div><div><h3>Conclusion</h3><p>The diagnosis of GDM using the two-step OGTT fails to identify subgroups of women with mild hyperglycemia that would benefit from treatment to lower the risk for adverse maternal and neonatal outcomes. Treatment of women with mild hyperglycemia decreased the risk of LGA and birthweight &gt;4000 g by 3-fold.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9952260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of yoga on reducing glycaemic variability in individuals with type 2 diabetes: A randomised controlled trial","authors":"Venugopal Vijayakumar,&nbsp;Ramesh Mavathur,&nbsp;Subramanian Kannan,&nbsp;Manjunath N.K. Sharma,&nbsp;Nagarathna Raguram,&nbsp;Maheshkumar Kuppusamy","doi":"10.1016/j.diabet.2023.101457","DOIUrl":"10.1016/j.diabet.2023.101457","url":null,"abstract":"","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10155426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline and longitudinal trajectories of body-mass index and all-cause mortality among patients with type 2 diabetes","authors":"Zongming Yang ,&nbsp;Peng Shen ,&nbsp;Yanlin Qu ,&nbsp;Lisha Xu ,&nbsp;Tiezheng Li ,&nbsp;Zhanghang Zhu ,&nbsp;Yonghao Wu ,&nbsp;Luhua Yu ,&nbsp;Kai Gao ,&nbsp;Xinhan Zhang ,&nbsp;Xuecheng Yao ,&nbsp;Lin Meng ,&nbsp;Hongbo Lin ,&nbsp;Liming Shui ,&nbsp;Mengling Tang ,&nbsp;Mingjuan Jin ,&nbsp;Kun Chen ,&nbsp;Jianbing Wang","doi":"10.1016/j.diabet.2023.101426","DOIUrl":"10.1016/j.diabet.2023.101426","url":null,"abstract":"<div><h3>Aim</h3><p>To investigate the associations of baseline body mass index (BMI) and longitudinal BMI trajectories with all-cause mortality among patients with type 2 diabetes mellitus (T2DM).</p></div><div><h3>Methods,</h3><p>We used data from the diabetes surveillance system of Yinzhou Health Information System with T2DM patients registered from 2010 to 2015. Participants aged ≥ 40 years were included and were followed up until September 30, 2021. The latent class growth mixture model was used to identify different changing patterns in BMI for 5 years from registration. Cox proportional hazards models were used to examine the associations of baseline BMI and 5-year BMI trajectories with all-cause mortality.</p></div><div><h3>Results</h3><p>We observed a nonlinear association between baseline BMI and all-cause mortality (<em>P</em> for nonlinearity &lt; 0.001), with an increased risk of death for low but not high BMI. However, compared with participants with medium-stable BMI for 5 years from baseline, individuals with increasing BMI had higher mortality, with adjusted hazard ratios (95% confidence intervals) 1.21 (1.02;1.43) for early-increasing and 1.47 (1.19;1.80) for late-sharp increasing groups.</p></div><div><h3>Conclusion</h3><p>These findings suggest that while obesity itself may not be associated with an increased risk for mortality, weight gain, and in particular rapid weight gain, is a risk factor for mortality among patients with T2DM.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10217396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concise review of lipidomics in nonalcoholic fatty liver disease","authors":"Sarah Béland-Bonenfant ,&nbsp;Alexia Rouland ,&nbsp;Jean-Michel Petit ,&nbsp;Bruno Vergès","doi":"10.1016/j.diabet.2023.101432","DOIUrl":"10.1016/j.diabet.2023.101432","url":null,"abstract":"<div><p>Nonalcoholic fatty liver disease (NAFLD) encompasses simple liver steatosis, nonalcoholic steatohepatitis (NASH), and liver fibrosis that can progress to cirrhosis. NAFLD has become the principal cause of chronic liver disease in many parts of the world. Lipidomic studies, by allowing to determine concentrations of lipid classes and fatty acid composition of different lipid species, have been of great interest to help understand NAFLD pathophysiology and potentially identify novel biomarkers for diagnosis and prognosis. Indeed, lipidomic data give information on qualitative lipid abnormalities associated with NAFLD. The aim of our article was to create a comprehensive and more synthetic review of main results from lipidomic studies in NAFLD. Literature was searched for all human lipidomic studies evaluating plasma samples of individuals with NAFLD. Results were regrouped by the degree of liver damage, either simple steatosis, NASH or liver fibrosis, and presented by lipid categories. Overall, we summarized the main lipidomic abnormalities associated with NAFLD as follows: modification of free fatty acid distribution, increase in ceramides, reduced phosphatidylcholine / phosphatidylethanolamine ratio, and increase in eicosanoids. These lipid abnormalities are likely to promote NASH and liver fibrosis by inducing mitochondrial dysfunction, apoptosis, inflammation, oxidation, and endoplasmic reticulum stress. Although these lipidomic abnormalities are consistently reported in many studies, further research is needed to clarify whether they may be predictive for liver steatosis, NASH or liver fibrosis.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9843696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addition of fenofibrate to statins is associated with risk reduction of diabetic retinopathy progression in patients with type 2 diabetes and metabolic syndrome: A propensity-matched cohort study","authors":"Nam Hoon Kim ,&nbsp;Jimi Choi ,&nbsp;Young Ho Kim ,&nbsp;Hwa Lee ,&nbsp;Sin Gon Kim","doi":"10.1016/j.diabet.2023.101428","DOIUrl":"10.1016/j.diabet.2023.101428","url":null,"abstract":"<div><h3>Aim</h3><p>This study aimed to determine the association between fenofibrate added to statin therapy and diabetic retinopathy progression.</p></div><div><h3>Methods</h3><p>In this propensity-matched study using the Korean National Health Insurance Service cohort (2002–2019), patients with type 2 diabetes and metabolic syndrome (≥ 30 years) receiving statin therapy were matched 1:2 by propensity score into the statin plus fenofibrate group (<em>n</em> = 22,395) and statin-only group (<em>n</em> = 43,191). The primary outcome was a composite of diabetic retinopathy progression including vitreous hemorrhage, vitrectomy, laser photocoagulation, intravitreous injection therapy and retinal detachment.</p></div><div><h3>Results</h3><p>The median (quartiles) follow-up duration was 44.0 (27.6–70.6) months. For the primary outcome, the incidence rate per 1,000 person-years was 9.66 in the statin-only group and 8.68 in the statin-plus-fenofibrate group. The risk of the primary outcome was significantly lower (hazard ratio [HR]=0.88; 95% confidence interval [0.81;0.96] <em>P</em> = 0.005) in the statin-plus-fenofibrate group than in the statin-only group. Only patients with pre-existing retinopathy showed benefits from fenofibrate treatment (HR=0.83 [0.73;0.95] <em>P</em> = 0.006). In addition, the statin plus fenofibrate group exhibited significantly lower risks of vitreous hemorrhage (HR= 0.86 [0.75;0.995] <em>P</em> = 0.042), laser photocoagulation (HR=0.86 [0.77;0.96] <em>P</em> = 0.009) and intravitreous injection therapy (HR=0.73 [0.59;0.90] <em>P</em> = 0.003) than those in the statin-only group. There was no significant interaction between the different characteristics at baseline and the treatment effect.</p></div><div><h3>Conclusion</h3><p>The addition of fenofibrate to statins was associated with significantly lower risk of diabetic retinopathy progression than statin therapy alone in patients with type 2 diabetes and metabolic syndrome.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9841475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between glycemic status and age-related macular degeneration: A nationwide population-based cohort study","authors":"Hyungwoo Lee ,&nbsp;Kyung-Do Han ,&nbsp;Jinyoung Shin","doi":"10.1016/j.diabet.2023.101442","DOIUrl":"10.1016/j.diabet.2023.101442","url":null,"abstract":"<div><h3>Aim</h3><p>The risk of dry and wet age-related macular degeneration (AMD) based on fasting glucose levels and disease duration of type 2 diabetes was investigated.</p></div><div><h3>Methods</h3><p>Using a health insurance claims database and the results of health examinations in South Korea, we conducted a retrospective, population-based cohort study of 2,103,604 adults ≥ 45 years of age who were AMD-free based on health checkups in 2009 and observed from January 1, 2011, to December 31, 2018. Glycemic status was classified into five groups: normal, impaired fasting glucose, new-onset diabetes (fasting glucose level ≥ 126 mg/dl but no diabetes diagnosis or diabetes medication), diabetes diagnosis &lt; 5 years, and diabetes ≥ 5 years. According to the presence and absence of choroidal neovascularization, AMD was classified as wet AMD and dry AMD, respectively. Adjusted hazard ratios (HRs) of AMD occurrence were estimated in each category.</p></div><div><h3>Results</h3><p>For dry AMD (<em>n</em> = 36,271, 1.72%), the HR was 1.192 (1.141–1.245) among subjects with diabetes &lt; 5 years and 1.294 (1.242–1.349) among subjects with diabetes ≥ 5 years compared with subjects with normal glycemic status after adjusting for age, sex, body mass index, lifestyle, and medical history. For wet AMD (<em>n</em> = 12,912, 0.61%), the HR was 1.103 (1.011–1.203) among subjects with new-onset diabetes, 1.252 (1.167–1.344) among subjects with diabetes &lt; 5 years, and 1.506 (1.413–1.605) among subjects with diabetes ≥ 5 years. The HR of AMD was significantly increased among participants ≤ 65 years old and those who did not have hypertension.</p></div><div><h3>Conclusions</h3><p>The incidence of dry and wet AMD increased among diabetes patients compared to the normal glycemic status group. These risks increased when the duration of diabetes was 5 years or more. The risk of wet AMD was increased among new-onset diabetes patients. These results suggest that high blood glucose levels without treatment might induce the vision-threatening condition of wet AMD, emphasizing the importance of early blood glucose management.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9831523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal autoimmune disease associated with a higher risk of offspring with type 1 diabetes: A nationwide mother-child cohort study in Taiwan","authors":"Fu-Shun Yen ,&nbsp;Jing-Yang Huang ,&nbsp;Shih-Yi Lin ,&nbsp;Pei-Lun Liao ,&nbsp;James Cheng-Chung Wei","doi":"10.1016/j.diabet.2023.101443","DOIUrl":"10.1016/j.diabet.2023.101443","url":null,"abstract":"<div><h3>Aim</h3><p>The incidence of type 1 diabetes continues to increase. However, the strategies to prevent or reduce its occurrence are inadequate. Therefore, we attempted to investigate if mothers with autoimmune disease were more likely to have children with type 1 diabetes.</p></div><div><h3>Methods</h3><p>We identified 1,288,347 newborns from the Taiwan Maternal and Child Health Database between January 1, 2009, and December 31, 2016, and followed them up to December 31, 2019. We used a multivariable Cox regression model to compare the childhood-onset type 1 diabetes risk between children whose mother had or did not have an autoimmune disease.</p></div><div><h3>Results</h3><p>The multivariable model demonstrated significantly higher risks of type 1 diabetes in the children with maternal autoimmune disease (aHR 1.55, 95% CI 1.16–2.08), type 1 diabetes (aHR 11.33, 95% CI 4.62–27.77), Hashimoto's thyroiditis (aHR 3.73, 95% CI 1.70–8.15), and inflammatory bowel diseases (aHR 2.00, 95% CI 1.07–3.76).</p></div><div><h3>Conclusion</h3><p>This nationwide mother and child cohort study showed a higher risk of type 1 diabetes in the children whose mothers had autoimmune disease, including Hashimoto's thyroiditis, and inflammatory bowel diseases.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10199457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening strategies for glucose tolerance abnormalities and diabetes in people with cystic fibrosis","authors":"Laurence Weiss ,&nbsp;Philippe Reix ,&nbsp;Helen Mosnier-Pudar ,&nbsp;Olivia Ronsin ,&nbsp;Jacques Beltrand ,&nbsp;Quitterie Reynaud ,&nbsp;Laurent Mely ,&nbsp;Pierre-Régis Burgel ,&nbsp;Nathalie Stremler ,&nbsp;Luc Rakotoarisoa ,&nbsp;Alfonso Galderisi ,&nbsp;Kevin Perge ,&nbsp;Nathalie Bendelac ,&nbsp;Michel Abely ,&nbsp;Laurence Kessler","doi":"10.1016/j.diabet.2023.101444","DOIUrl":"10.1016/j.diabet.2023.101444","url":null,"abstract":"<div><p>The increase in life expectancy of patients with cystic fibrosis has come with new comorbidities, particularly diabetes. The gradual development of glucose tolerance abnormalities means that 30 to 40% of adults will be diabetic. Cystic fibrosis–related diabetes is a major challenge in the care of these patients because it is a morbidity and mortality factor at all stages of the disease. Early glucose tolerance abnormalities observed from childhood, before the stage of diabetes, are also associated with a poor pulmonary and nutritional outcome. The long asymptomatic period justifies systematic screening with an annual oral glucose tolerance test from the age of 10 years. However, this strategy does not take into account the new clinical profiles of patients with cystic fibrosis, recent pathophysiological knowledge of glucose tolerance abnormalities, and the emergence of new diagnostic tools in diabetology. In this paper, we summarise the challenges of screening in the current context of new patient profiles – patients who are pregnant, have transplants, or are being treated with fibrosis conductance transmembrane regulator modulators – and put forward an inventory of the various screening methods for cystic fibrosis–related diabetes, including their applications, limitations and practical implications.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10199479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and incidence of cardiovascular and renal diseases in type 1 compared with type 2 diabetes: A nationwide French observational study of hospitalized patients","authors":"Pierre Henri Ducluzeau ,&nbsp;Grégoire Fauchier ,&nbsp;Julien Herbert ,&nbsp;Carl Semaan ,&nbsp;Jean Michel Halimi ,&nbsp;Denis Angoulvant ,&nbsp;Laurent Fauchier","doi":"10.1016/j.diabet.2023.101429","DOIUrl":"10.1016/j.diabet.2023.101429","url":null,"abstract":"<div><h3>Background</h3><p>Type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) increase risks of cardiovascular (CV) and renal disease compared with diabetes-free populations. There are only a few studies comparing T1DM and T2DM for the relative risk of these clinical events.</p></div><div><h3>Methods</h3><p>All adult patients hospitalized in French hospitals in 2013 with at least 5 years of follow-up were identified and categorized by their diabetes status. A total of 50,623 patients with T1DM (age 61.4 ± 18.6, 53% male) and 425,207 patients with T2DM (age 68.6 ± 14.3, 55% male) were followed over a median period of 5.3 years (interquartile range: 2.8 - 5.8 years). Prevalence and event rates of myocardial infarction (MI), heart failure (HF), ischemic stroke, chronic kidney disease (CKD), all-cause death and CV death were assessed with age stratification of 10-year intervals. For clinical events during follow-up, we report hazard ratios (HRs) in T1DM relative to T2DM.</p></div><div><h3>Results</h3><p>The age and sex-adjusted prevalence of CV diseases was higher in T2DM for ages above 40 years whereas the prevalence of CKD was more common in T1DM between ages 18 and 70 years. During 2,033,239 person-years of follow-up, age and sex-adjusted HR event rates comparing T1DM, versus T2DM as reference, showed that MI and HF relative risks were increased above 60 years (1.2 and 1.4 -fold). HR of ischemic stroke did not markedly differ between T1DM and T2DM. Risk of incident CKD was 2.4-fold higher in T1DM above 60 years. All-cause death HR risk was 1.1-fold higher in T1DM after 60 years and the CV death risk was 1.15-fold higher in T1DM between 60 and 69 years compared to T2DM.</p></div><div><h3>Conclusions</h3><p>Although the crude prevalent burden of CV diseases may be lower in T1DM than in T2DM, patients with T1DM may have a higher risk of incident MI, HF, all-cause death and CV death above 60 years of age, highlighting the need for improved prevention in this population.</p></div>","PeriodicalId":11334,"journal":{"name":"Diabetes & metabolism","volume":null,"pages":null},"PeriodicalIF":7.2,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10198952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}