Background: Previous trials indicated that intensive glucose lowering in treatment of patients with type 2 diabetes mellitus (T2DM) was associated with a higher incidence of mortality. We therefore conducted a meta-analysis to evaluate the benefits and harms of intensive glucose lowering therapy in treatment of T2DM patients on major cardiovascular outcomes.
Methods: Randomized controlled trials (RCTs) were obtained from searches of PubMed, EmBase, and the Cochrane Library electronic databases until Feb. 2016. Relative risk (RR) was used to measure the treatment effect by random-effect model. Meta-regression, sensitivity analyses, subgroup analyses, and publication biases were also conducted.
Results: Thirteen RCTs were included with 58,160 T2DM patients and reported 5719 major cardiovascular events (MACEs), 6569 deaths, 2057 cardiac death cases, 3201 myocardial infarction (MI) cases, 1835 stroke cases, and 1778 congestive heart failure cases. Intensive glucose lowering therapy significantly reduced risk of MACEs (RR: 0.92; 95%CI: 0.85-1.00; P=0.042), and MI (RR: 0.90; 95%CI: 0.82-0.98; P=0.020) compared with conventional glucose control therapy. Furthermore, intensive glucose lowering therapy has no significant effect on the incidence of total mortality (RR: 0.98; 95%CI: 0.91-1.07; P=0.693), cardiac death (RR: 1.00; 95%CI: 0.87-1.04; P=0.999), stroke (RR: 0.94; 95%CI: 0.84-1.06; P=0.333), and congestive heart failure (RR: 1.19; 95%CI: 0.96-1.48; P=0.108).
Conclusion: T2DM patients who received intensive glucose lowering therapy are associated with a reduced risk of MACEs and MI, whereas it has no significant effect on the risk of total mortality, cardiac death, stroke, and congestive heart failure. These effects might differ when stratified by baseline characteristics in T2DM patients.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ijcard.2016.04.163 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The effects of ultra-selective beta1-antagonism on the metabolic and cytokine profile in septic shock patients receiving noradrenaline: a sub-investigation from the STRESS-L Randomised Study.
Intensive Care Med Exp
January 2025
Department of Life Sciences, Aberystwyth University, Ceredigion, UK.
Purpose: The landiolol and organ failure in patients with septic shock (STRESS-L study) included a pre-planned sub-study to assess the effect of landiolol treatment on inflammatory and metabolomic markers.
Methods: Samples collected from 91 patients randomised to STRESS-L were profiled for immune and metabolomic markers. A panel of pro- and anti-inflammatory cytokines were measured through commercially acquired multiplex Luminex assays and statistically analysed by individual and cluster-level analysis (patient).
Evaluation of the predictive value of the glucose-to-potassium ratio in predicting in-hospital mortality of patients with sepsis and septic shock.
Med Klin Intensivmed Notfmed
January 2025
Ankara Training and Research Hospital, Department of Emergency Medicine, University of Health Sciences, Ankara, Turkey.
Background: In this study, we aimed to evaluate the role of the glucose-to-potassium ratio in predicting in-hospital mortality and prognosis of patients diagnosed with sepsis and septic shock in an emergency department and admitted to an emergency critical intensive care unit (ICU).
Methods: This study was a retrospective and observational evaluation of nontraumatic sepsis and septic shock patients > 18 years of age who were admitted to the emergency department of a tertiary training and research hospital and had available glucose and potassium values at the time of admission. The patients were evaluated over a 24-month period.
Infants of Diabetic Mothers and Associated Complications in the Neonatal Intensive Care Unit.
Cureus
December 2024
Pediatrics, King Faisal University, Al-Hofuf, SAU.
Background The incidence of pregnancy-associated diabetes has increased in recent decades, leading to neonatal adverse outcomes like metabolic and hematologic disorders, respiratory distress, cardiac disorders, and neurologic impairment. Macrosomia, a common consequence of diabetes, is influenced by maternal blood glucose levels, impacting adverse neonatal outcomes. Aim The current study aimed to assess the neonatal and maternal outcomes of the infants of diabetic mothers.
View Article and Find Full Text PDFLoss or inhibition of lysosomal acid lipase leads to cholesteryl ester accumulation without affecting muscle formation or mitochondrial function.
BBA Adv
December 2024
Gottfried Schatz Research Center, Molecular Biology and Biochemistry, Medical University of Graz, Graz, Austria.
Skeletal muscle (SM) is essential for movement, stability, and overall body function, and it readily adapts to changes in energy demand. Myogenesis is energy-intensive and involves complex molecular and cellular events. We recently demonstrated that the absence of lysosomal acid lipase (LAL) significantly impacts the SM phenotype, primarily by disrupting energy homeostasis and reducing ATP production.
View Article and Find Full Text PDFHypoglycemia and hospital mortality in critically ill patients.
Sci Rep
January 2025
Department of Critical Care Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan.
Prior research has indicated that adopting strict glycemic control measures might elevate the risk of hypoglycemia and result in higher mortality rates among critically ill patients. However, there is a lack of studies investigating the incidence of hypoglycemia and its consequential outcomes in real-world clinical settings. This retrospective cohort study was conducted at Taichung Veterans General Hospital, utilizing critical care databases covering the period from 2015 to 2020.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!