Journal of the Royal Society of Medicine最新文献

{"title":"SGLT2 inhibitors for primary prevention of macrovascular and major microvascular complications in type 2 diabetes: an island-wide cohort study.","authors":"Wan-Yin Cheng, Fu-Shun Yen, Yao-Min Hung, James Cheng-Chung Wei, Heng-Jun Lin, Yu-Han Huang, Chih-Cheng Hsu, Chii-Min Hwu","doi":"10.1177/01410768251375906","DOIUrl":"10.1177/01410768251375906","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the different risks of developing cardiovascular disease and major microvascular complications between sodium-glucose cotransporter-2 inhibitors (SGLT2i) and non-SGLT2i users in patients with type 2 diabetes (T2D) who do not have existing macrovascular or microvascular diseases.</p><p><strong>Design: </strong>This study employed a retrospective, population-based cohort study design.</p><p><strong>Setting: </strong>Data were obtained from Taiwan's National Health Insurance Research Database, covering the period from January 1, 2008, to December 31, 2021. Propensity score matching was used to identify 91,327 matched pairs of SGLT2 inhibitor and dipeptidyl peptidase-4 (DPP-4) inhibitor users, 91,673 pairs of SGLT2 inhibitor and sulfonylurea users, and 20,857 pairs of SGLT2 inhibitor and glucagon-like peptide-1 receptor agonist (GLP-1 RA) users.</p><p><strong>Participants: </strong>The study included 1,145,035 patients diagnosed with T2D from the NHIRD.</p><p><strong>Main outcome measures: </strong>Cox proportional hazard models were used to assess the risk of outcomes.</p><p><strong>Results: </strong>SGLT2i users showed a lower risk of coronary artery disease (0.80 (0.73-0.87), 0.78 (0.72-0.85) and 0.74 (0.64-0.86)), heart failure (0.44 (0.38-0.49), 0.56 (0.50-0.62) and 0.66 (0.55-0.78)), cardiovascular death (0.47 (0.40-0.56), 0.47 (0.40-0.55) and 0.68 (0.53-0.87)), dialysis (0.03 (0.02-0.05), 0.13 (0.10-0.17) and 0.16 (0.11-0.23)), vision-threatening retinopathy (0.58 (0.51-0.67), 0.59 (0.51-0.67) and 0.78 (0.62-0.98)), amputation (0.29 (0.20-0.41), 0.28 (0.21-0.38) and 0.61 (0.46-0.89)) and all-cause mortality (0.42 (0.39-0.445), 0.39 (0.37-0.42) and 0.68 (0.61-0.76]))when compared to DPP-4 inhibitors, sulfonylureas, and GLP-1 RA users, respectively.</p><p><strong>Conclusions: </strong>This study showed that SGLT2i use was associated with a lower risk of incident cardiovascular diseases, major microvascular complications and mortality compared with the use of DPP-4 inhibitors, sulfonylureas and GLP-1 RA in patients with T2D, who did not have macrovascular and microvascular diseases.</p>","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"347-357"},"PeriodicalIF":7.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12583002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145431747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The unsolved complexities inherent in informed patient choice.","authors":"Kamran Abbasi","doi":"10.1177/01410768251406499","DOIUrl":"10.1177/01410768251406499","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":"118 11","pages":"343"},"PeriodicalIF":7.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12681593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical decision-making: sometimes variation is appropriate.","authors":"John Howat, Sarah Gardiner, Dieneke Hubbeling","doi":"10.1177/01410768251363078","DOIUrl":"10.1177/01410768251363078","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"344"},"PeriodicalIF":7.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 10-year NHS plan needs a workforce equity foundation.","authors":"Richard Antony Powell, Vijay Nayar, Mo Al-Haddad, Partha Kar, Ganesh Sathyamoorthy, Mala Rao","doi":"10.1177/01410768251389442","DOIUrl":"10.1177/01410768251389442","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"345-346"},"PeriodicalIF":7.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12646925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145604815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting informed health choices: the long and winding road.","authors":"Andrew D Oxman, Iain Chalmers, Paul P Glasziou","doi":"10.1177/01410768251384317","DOIUrl":"10.1177/01410768251384317","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"358-372"},"PeriodicalIF":5.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12588968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145445271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forgetting is the clinical skill that separates human doctors from AI.","authors":"Waseem Jerjes, See Chai Carol Chan, Azeem Majeed","doi":"10.1177/01410768251394834","DOIUrl":"10.1177/01410768251394834","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":"118 11","pages":"373-374"},"PeriodicalIF":7.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12681673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ReSPECT at the bedside - between design and reality.","authors":"Christina Lok Ming Wong, Lucy-Anne Frank","doi":"10.1177/01410768251362989","DOIUrl":"10.1177/01410768251362989","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"316"},"PeriodicalIF":7.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Failing to learn? The NHS is losing its capacity for system-wide safety investigation.","authors":"Carl Macrae","doi":"10.1177/01410768251366879","DOIUrl":"10.1177/01410768251366879","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"317-319"},"PeriodicalIF":7.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fail to learn, learn to fail: a warning for the NHS.","authors":"Kamran Abbasi","doi":"10.1177/01410768251397925","DOIUrl":"10.1177/01410768251397925","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":"118 10","pages":"315"},"PeriodicalIF":7.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12681667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical failure: the unaddressed challenge.","authors":"Waseem Jerjes, Azeem Majeed","doi":"10.1177/01410768251366871","DOIUrl":"10.1177/01410768251366871","url":null,"abstract":"","PeriodicalId":17271,"journal":{"name":"Journal of the Royal Society of Medicine","volume":" ","pages":"320-324"},"PeriodicalIF":7.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12679375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}