Diabetes epidemiology and management最新文献

{"title":"Dexamethasone use and insulin requirements in coronovirus-19 (COVID-19) infection stratified by Hemoglobin A1c","authors":"Caitlyn Gordon ,&nbsp;Barbara Kamel ,&nbsp;Lauren McKeon ,&nbsp;Danielle Brooks ,&nbsp;Rifka Schulman-Rosenbaum","doi":"10.1016/j.deman.2022.100123","DOIUrl":"10.1016/j.deman.2022.100123","url":null,"abstract":"<div><h3>Aims</h3><p>The study aimed to identify weight-based insulin requirements for dexamethasone-induced hyperglycemia in COVID-19 infection stratified by hemoglobin A1c (HbA1c).</p></div><div><h3>Methods</h3><p>This retrospective study assessed hospitalized patients ≥ 18 years admitted with COVID-19 and receiving ≥ 1 dose of dexamethasone 6 mG. Daily blood glucose (BG) and insulin doses were collected and organized by HbA1c.</p></div><div><h3>Results</h3><p>Among 45 patients with available HbA1c, 100% [HbA1c ≥ 7%] and 72% [HbA1c &lt; 7%] developed hyperglycemia (BG ≥180 mG/dL). Median daily insulin (Interquartile Range) (units/kG/day) was 0.03 (0, 0.32) [HbA1c 6–6.9%], 0.1 (0.06, 0.36) [HbA1c 7–7.9%], 0.66 (0.39, 0.69) [HbA1c 8–8.9%], and 0.72 (0.63, 0.78) [HbA1c ≥ 9%]. On day 10 of dexamethasone, when majority of patients were at goal BG, patients required 0.07 (0.01, 0.31) [HbA1c 6–6.9%], 0.59 (0.11, 0.75) [HbA1c 7–7.9%], 1.15 (0.95, 1.35) [HbA1c 8–8.9%], and 1.14 units/kG/day [HbA1c ≥ 9%]. Of 24 patients completing 10 days of dexamethasone, 25% experienced hypoglycemia (BG &lt; 70 mG/dL) upon discontinuation.</p></div><div><h3>Conclusion</h3><p>Patients with higher HbA1c experienced greater dexamethasone-induced hyperglycemia and required higher insulin doses. Inpatient insulin dosing algorithms should take into consideration baseline HbA1c to avoid delays in achieving normoglycemia.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"10 ","pages":"Article 100123"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9733297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9795281","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}

{"title":"Clinical characteristics and prognoses of patients with diabetic ketoacidosis in Finland","authors":"Elena Putula ,&nbsp;Heini Huhtala ,&nbsp;Sini Vanhamäki ,&nbsp;Tiina Laatikainen ,&nbsp;Aapo Tahkola ,&nbsp;Päivi Hannula ,&nbsp;Saara Metso","doi":"10.1016/j.deman.2023.100129","DOIUrl":"10.1016/j.deman.2023.100129","url":null,"abstract":"<div><h3>Aims</h3><p>To assess the prognosis and risk factors for diabetic ketoacidosis (DKA) in Tampere University Hospital (Tays) in a retrospective case-control study.</p></div><div><h3>Methods</h3><p>All 282 patients (age ≥15 years) treated for DKA in Tays during the period 2014–2020 were included. A total of 846 controls adjusted for age, gender, diabetes type and municipality, and without any DKA during follow-up were collected from the Finnish National Diabetes Registry. HbA1c, mental and behavioural disorders, and mortality obtained from the Finnish National Diabetes Registry were compared between patients with and without DKA.</p></div><div><h3>Results</h3><p>Patients’ median age was 36 years. Ten percent of the patients with DKA died during the median follow-up time of three years. Mortality rate was sixfold higher in patients with DKA than among the controls (OR 6.28; 95% CI 3.17–12.42). Patients with DKA had higher rates of substance abuse (OR 4.68; 95% CI 3.23–6.78) and depression (OR 2.24; 95% CI 1.58–3.18), and higher median HbA1c levels (84 vs. 61 mmol/mol, <em>p</em> &lt; 0.001). Nineteen percent of the DKA patients (<em>n</em> = 53) had recurrent DKA.</p></div><div><h3>Conclusions</h3><p>DKA is a strong indicator for premature death. Poor glycaemic control, depression and substance abuse are risk factors for DKA.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"10 ","pages":"Article 100129"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45497567","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}

{"title":"New insights into the currently available questionnaire for assessing impaired awareness of hypoglycaemia (IAH) among insulin-treated type 2 diabetes- A key risk factor for hypoglycaemia","authors":"Li Chang Ang ,&nbsp;Yong Mong Bee ,&nbsp;Su-Yen Goh ,&nbsp;Ming Ming Teh","doi":"10.1016/j.deman.2023.100136","DOIUrl":"10.1016/j.deman.2023.100136","url":null,"abstract":"<div><h3>Background</h3><p>Gold and Clarke questionnaire are originally developed to assess impaired awareness of hypoglycaemia (IAH) in type 1 diabetes. Present study examined the similarities and differences between the two questionnaires when administered to insulin-treated type 2 diabetes patients.</p></div><div><h3>Methods</h3><p>A total of 153 insulin-treated type 2 diabetes patients with mean age of 61.0±9.4 years and mean HbA1c of 8.4±1.5% completed questionnaire in diabetes outpatient clinics of tertiary-care hospital. Factor analysis was conducted to examine the psychometric properties of Clarke questionnaire. Spearman's correlation was used to examine convergent validity of Clarke questionnaire with Gold method.</p></div><div><h3>Results</h3><p>Bifactorial structure for Clarke questionnaire was identified, namely <em>Awareness of Hypoglycaemia</em> (Factor 1) and <em>Experience of Hypoglycaemia</em> (Factor 2). Clarke Factor 1 correlated strongly with Gold scores (r_s=0.77, p&lt;0.001), and yielded 22.9% prevalence of IAH using cut-off score of ≥2.5, which is comparable to Gold method of 19.6%.</p></div><div><h3>Conclusions</h3><p>Gold single-item questionnaire assesses hypoglycaemia awareness only while Clarke questionnaire assesses both hypoglycaemia awareness and severe hypoglycaemia events. There is a high degree of convergence between Gold and Clarke in hypoglycaemia awareness assessment among insulin-treated type 2 diabetes. Hence, these two questionnaires are similar but not interchangeable due to bifactorial nature of Clarke questionnaire.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"10 ","pages":"Article 100136"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43534366","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}

{"title":"Cardiovascular and renal outcomes with SGLT2 inhibitors: real-life observational studies in older patients with type 2 diabetes","authors":"A. Scheen","doi":"10.1016/j.deman.2023.100135","DOIUrl":"https://doi.org/10.1016/j.deman.2023.100135","url":null,"abstract":"","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54176927","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}

{"title":"Biopharmaceutics and clinical outcomes of emerging dosage forms of insulin: A systematic review","authors":"Emmanuel O. Olorunsola ,&nbsp;Imo E. Udoh ,&nbsp;Marvelene B. Ekott ,&nbsp;Mfonobong F. Alozie ,&nbsp;Koofreh G. Davies","doi":"10.1016/j.deman.2022.100120","DOIUrl":"10.1016/j.deman.2022.100120","url":null,"abstract":"<div><h3>Background</h3><p>Many works are ongoing with the aim of obtaining a more convenient way than the parenteral injection for administering insulin.</p></div><div><h3>Purpose</h3><p>To review the biopharmaceutics and clinical outcomes of the various emerging dosage forms of insulin so as to identify the promising formulations.</p></div><div><h3>Method</h3><p>A systematic literature search with analysis was carried out to obtain information on the biopharmaceutics and clinical outcomes of the emerging dosage forms.</p></div><div><h3>Results</h3><p>Intraperitoneal insulin was found to be characterized by direct drug delivery through the portal vein to the liver having bioavailability of 60%, but its clinical application is limited by the high risk of infection. The bioavailability of transdermal insulin has been enhanced using electrical, mechanical and physical techniques; and such formulations could achieve up to 39.5% blood glucose reduction. Oral insulin, known to be the most convenient, has its bioavailability limited to 1% by enzymatic degradation and poor absorption. Its challenges however, have been addressed by various interventions to achieve different levels of bioavailability up to 73.1%. Buccal insulin has shown potentials in managing postprandial hyperglycaemia without posing hypoglycaemic risk but its clinical applicability has not been established; whereas the long transit time, lower levels of peptidases and incorporation of permeation-enhancers have been shown to be responsible for the good treatment outcome of colon-targeted insulin. Rectal insulin with bioavailability of 11% has been shown to be considerably safe but not cost-effective while the ocular insulin is limited by poor absorption. Nasal tolerance and high rate of treatment failures were shown to be limiting intranasal insulin while the pulmonary insulin is being limited by peripheral drug retention and insulin resistance.</p></div><div><h3>Conclusion</h3><p>The biopharmaceutical profiles and clinical outcomes of transdermal, oral and colon-targeted insulin are superior to those of the other dosage forms. Further research works could be done towards the full development of these promising formulations.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"9 ","pages":"Article 100120"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49198130","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}

{"title":"The association between asymptomatic malaria and blood glucose among outpatients in a rural low-income setting","authors":"Francis Xavier Kasujja ,&nbsp;Fred Nuwaha ,&nbsp;Elizabeth Kiracho Ekirapa ,&nbsp;Ronald Kusolo ,&nbsp;Roy William Mayega","doi":"10.1016/j.deman.2022.100112","DOIUrl":"https://doi.org/10.1016/j.deman.2022.100112","url":null,"abstract":"<div><h3>Background</h3><p>Malaria and haemolysis have been linked to a preponderance of altered glycaemic indices. This study set out to estimate the association between asymptomatic malaria and the Fasting Plasma Glucose (FPG), glycated haemoglobin (HBA1c) and Oral Glucose Tolerance (OGT) tests.</p></div><div><h3>Methods</h3><p>A cross-sectional survey was conducted at a general hospital in eastern Uganda. Eligible participants were patients aged 30–75 years, seeking care at the outpatient department, of unknown diabetes status. Participants were tested for FPG, OGT and HBA1c tests. Multiple linear regression and ROC curve analysis were conducted for the three tests.</p></div><div><h3>Results</h3><p>A total of 504 participants were enrolled on the study, of whom 78.4% (395) were female. After adjusting for age, sex, and BMI, individuals with asymptomatic malaria had lower average HBA1c [-5 mmol/mol (95% CI, -7 -2) and OGT tests levels [-1.75 mmol/l (-2.6, -0.8)]. The optimal cut-off points for diabetes among individuals with asymptomatic malaria were lower for the HBA1c test [6.5% (47 mmol/mol) versus 6.6% (49 mmol/mol), respectively] but higher for the FPG test (6.6 mmol/l versus 6.2 mmol/l, respectively).</p></div><div><h3>Conclusions</h3><p>These findings may have implications for diabetes screening in malaria-endemic settings.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"9 ","pages":"Article 100112"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49759593","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}

{"title":"Comparison of diagnostic screening methods for diabetes in patients with heart failure","authors":"Yuta Ishikawa ,&nbsp;Emma M. Laing ,&nbsp;Alex K. Anderson ,&nbsp;Donglan Zhang ,&nbsp;Joseph M. Kindler ,&nbsp;Rupal Trivedi-Kapoor ,&nbsp;Elisabeth L. P. Sattler","doi":"10.1016/j.deman.2022.100109","DOIUrl":"10.1016/j.deman.2022.100109","url":null,"abstract":"<div><h3>Aims</h3><p>The objective of the study was to compare screening performances of HbA1c, fasting plasma glucose (FPG), and two-hour plasma glucose (2hPG) in heart failure (HF) patients.</p></div><div><h3>Methods</h3><p>We included 237 HF patients aged &gt;20 years without history of diabetes, using National Health and Nutrition Examination Survey data (2005–2016). American Diabetes Association diabetes screening criteria were used: (1) HbA1c ≥6.5%, (2) FPG ≥126 mg/dL, and (3) 2hPG ≥200 mg/dL. Sensitivity, specificity, predictive values, and Receiver Operating Characteristic (ROC) curves for HbA1c and FPG were examined against reference methods.</p></div><div><h3>Results</h3><p><em>N</em> = 50 patients (20.5%) met at least 1 of 3 clinical criteria for diabetes. 2hPG alone identified 70.5% of patients, whereas HbA1c alone identified only 27.0% of patients. Sensitivity and specificity using a HbA1c cutoff at ≥6.5% were 24.4% and 97.6%, respectively. The Youden's J statistic for HbA1c was maximized at 6.1%. The area under the ROC curve of HbA1c against 2hPG was significantly lower compared to FPG (0.79, 95% CI 0.70-0.88; 0.89, 95% CI 0.84-0.94, respectively; <em>p</em> = 0.04).</p></div><div><h3>Conclusions</h3><p>Blood glucose criteria are more sensitive than HbA1c when screening HF patients for diabetes. Future studies should test performance of a HbA1c cutoff at 6.1% when FPG or 2hPG cannot be completed.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"9 ","pages":"Article 100109"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44809850","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}

{"title":"Perception of artificial intelligence-based solutions in healthcare among people with and without diabetes: A cross-sectional survey from the health in Central Denmark cohort","authors":"Jonas F.R. Schaarup ,&nbsp;Ravi Aggarwal ,&nbsp;Else-Marie Dalsgaard ,&nbsp;Kasper Norman ,&nbsp;Ole Lindgård Dollerup ,&nbsp;Hutan Ashrafian ,&nbsp;Daniel R. Witte ,&nbsp;Annelli Sandbæk ,&nbsp;Adam Hulman","doi":"10.1016/j.deman.2022.100114","DOIUrl":"10.1016/j.deman.2022.100114","url":null,"abstract":"<div><h3>Background</h3><p>Patients’ acceptance of artificial intelligence (AI) based health-related technologies depend strongly on their perception and trust of AI. This research field has not been studied extensively, especially among people living with diabetes. A large proportion of them frequently use health technologies in their everyday lives to manage their condition, which may make them more prepared to adopt AI-based solutions. Our study aimed to investigate the perception of AI-based solutions in healthcare, and characteristics associated with positive attitudes towards AI among people with and without diabetes.</p></div><div><h3>Methods</h3><p>An online survey was sent to 12,755 participants in the Health in Central Denmark cohort, including 10 questions and six scenarios related to current technology use, data sharing, and AI. The question on benefits and risks of AI, and the responses to the scenarios were used as outcomes. Multinomial logistic regression was used to examine which characteristics were associated with seeing the benefit of AI over the risks, including diabetes status, age, sex, education, health literacy, the use of wearable devices, and views on data sharing. A similar analysis was conducted on the acceptance of AI-based solutions in healthcare-related scenarios.</p></div><div><h3>Findings</h3><p>8,420 participants responded to the survey. Most participants (88%) had previously heard about AI. 46% of participants agreed with the statement that the benefits of AI outweigh the risks, while only 2% agreed with the opposite statement, and 30% were unsure. We did not find evidence for a differential opinion by diabetes status. Having diabetes was associated with less openness to replace healthcare professionals by AI-based technologies, although most people were still open to AI if controlled by humans.</p></div><div><h3>Interpretation</h3><p>Despite the generally positive perception of AI and its benefits to healthcare, human interaction seemed to play an important role in defining positive attitudes to AI across different healthcare scenarios, especially among people with diabetes. This highlights the pressing need for a patient-centered development process of AI-based solutions in the future.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"9 ","pages":"Article 100114"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45634860","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}

{"title":"PRODIAB: Perspectives on the use of patient-reported outcome measures among diabetic patients","authors":"Nicolas Naïditch ,&nbsp;Coline Hehn ,&nbsp;Amine Ounajim ,&nbsp;Guy Fagherazzi ,&nbsp;Antonia Gasch-Illescas ,&nbsp;Ben Braithwaite ,&nbsp;Jean-François Thébaut","doi":"10.1016/j.deman.2023.100128","DOIUrl":"10.1016/j.deman.2023.100128","url":null,"abstract":"<div><p>Patient Reported Outcome Measures (PROMs) are recognized by health authorities as fundamental and can be evaluated by several questionnaires. The main complexity of evaluating PROMs in People with Diabetes (PwD), be it type 1 (PwT1D) or type 2 (PwT2D), is choosing the right tool (generic or specific) with the right constructs. This study explores the use of PROMs in PwD. The main objective was to compare generic and specific QoL PROMs in a diabetic population. The secondary objective was to assess potential overlaps of assessed constructs in the different PROMs frequently used in diabetes.</p><p>PRODIAB was an online quantitative survey conducted between January and February 2022. The scientific committee selected the following oft-used questionnaires: EuroQol 5-Dimensions 5-Level (EQ-5D-5L), Audit of Diabetes Dependent Quality of Life (ADDQOL), Treatment Burden Questionnaire (TBQ), Hospital Anxiety and-Depression Scale (HADS-A; HADS-D) and Patient-Health-Questionnaire-9 (PHQ-9). All PROMs used were validated in French.</p><p>Responses from 2,796 French PwD were analyzed. Compared to PwT2D, PwT1D reported a better general Quality of Life (QoL) on the EQ-5D-5L index (0.75 vs 0.66; <em>p</em> &lt; 0.001) and a lower specific QoL on the ADDQOL (-2.8 vs -2.5; <em>p</em> &lt; 0.001). Adjusted analysis showed that age was inversely associated with EQ-5D-5L index score (-0.11; <em>p</em> &lt; 0.001) and a positively associated with ADDQOL score (0.14; <em>p</em> &lt; 0.001). All PROMs were significantly correlated with each other and the HADS-A, HADS-D and PHQ9 (<em>r</em> 0.60 to 0.72) even more so. While principal component analyses suggested that all PROMs measured only one dimension (mental health) (eigenvalue=3.39; first dimension percentage of variance 56.5), adjusted analyses suggested that the EQ-5D-5L is not adequate for assessing the specific impact of diabetes on QoL.</p><p>Our study emphasizes the importance of identifying the constructs assessed by each PROM as well as the target population in order to choose the best-suited questionnaire type with the most appropriate constructs.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"9 ","pages":"Article 100128"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42735825","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}

{"title":"Lower risks of new-onset acute pancreatitis and pancreatic cancer in sodium glucose cotransporter 2 (SGLT2) inhibitors compared to dipeptidyl peptidase-4 (DPP4) inhibitors: A propensity score-matched study with competing risk analysis","authors":"Oscar Hou In Chou ,&nbsp;Jiandong Zhou ,&nbsp;Jonathan V Mui MBBChir ,&nbsp;Danish Iltaf Satti ,&nbsp;Cheuk To Chung ,&nbsp;Teddy Tai Loy Lee ,&nbsp;Sharen Lee ,&nbsp;Edward Christopher Dee ,&nbsp;Kenrick Ng MBBChir ,&nbsp;Bernard Man Yung Cheung ,&nbsp;Fengshi Jing ,&nbsp;Gary Tse","doi":"10.1016/j.deman.2022.100115","DOIUrl":"https://doi.org/10.1016/j.deman.2022.100115","url":null,"abstract":"<div><h3>Background</h3><p>Dipeptidyl peptidase-4 inhibitors (DPP4I) may be associated with higher risks of acute pancreatitis and pancreatic cancer. This study compared the risks of acute pancreatitis and pancreatic cancer between sodium glucose cotransporter 2 inhibitors (SGLT2I) and DPP4I users.</p></div><div><h3>Methods</h3><p>This was a retrospective population-based cohort study of patients with type-2 diabetes mellitus on either SGLT2I or DPP4I between January 1^st, 2015, and December 31^st 2020 in Hong Kong. The primary outcome was new-onset acute pancreatitis and pancreatic cancer. Propensity score matching (1:1 ratio) using the nearest neighbour search was performed. Univariable and multivariable Cox regressions were applied to identify significant predictors.</p></div><div><h3>Results</h3><p>This cohort included 31609 Type 2 Diabetes Mellitus patients (median age: 67.4 years old [SD: 12.5]; 53.36% males). 6479 patients (20.49%) used SGLT2I, and 25130 patients (70.50%) used DPP4I. After matching, the rate of acute pancreatitis was significantly lower in SGLT2I users compared to DPP4I users. Multivariable Cox regression showed that SGLT2I use was associated with lower risks of acute pancreatitis (Hazard ratio, HR: 0.11; 95% Confidence interval, CI: 0.02-0.51; P=0.0017) and pancreatic cancer (HR: 0.22; 95% CI: 0.039-0.378; P=0.0003). The results were consistent using competing risk models and different propensity score approaches.</p></div><div><h3>Conclusions</h3><p>SGLT2I use was associated with lower risks of new-onset acute pancreatitis and pancreatic cancer after propensity score matching and multivariable adjustment, underscoring the need for further evaluation in the randomised controlled trial setting.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"9 ","pages":"Article 100115"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49751615","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}