Aim: We aimed to determine the macrovascular and microvascular outcomes of intensive versus standard glucose-lowering strategies in type 2 diabetes (T2D) and investigate the relationships between these outcomes and trial arm glycated haemoglobin (HbA1c) reduction.
Materials And Methods: In this systematic review and meta-analysis, we identified relevant trials from MEDLINE, Embase, the Cochrane Library, and bibliographies up to August 2023. Macrovascular and microvascular outcomes, along with safety outcomes, were evaluated. Pooled study-specific hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated, and meta-regression was employed to analyse the relationships between outcomes and HbA1c reduction.
Results: We included 11 unique RCTs involving 51 469 patients with T2D (intensive therapy, N = 26 691; standard therapy, N = 24 778). Intensive versus standard therapy reduced the risk of non-fatal myocardial infarction (MI) (HR 0.84; 95% CI 0.75-0.94) with no difference in the risk of major adverse cardiovascular events (HR 0.97; 95% CI 0.92-1.03) and other adverse cardiovascular outcomes. Intensive versus standard therapy reduced the risk of retinopathy (HR 0.85; 0.78-0.93), nephropathy (HR 0.71; 0.58-0.87) and composite microvascular outcomes (HR 0.88; 0.77-1.00). Meta-regression analyses showed modest evidence of inverse linear relationships between HbA1c reduction and the outcomes of major adverse cardiovascular events, non-fatal MI, stroke and retinopathy, but these were not statistically significant.
Conclusions: In people with T2D, intensive glucose control was associated with a reduced risk of non-fatal MI and several microvascular outcomes, particularly retinopathy and nephropathy. The lack of an effect of intensive glucose-lowering on most macrovascular outcomes calls for a more comprehensive approach to managing cardiovascular risk factors alongside glycaemic control.
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http://dx.doi.org/10.1111/dom.15511 | DOI Listing |
Cell Biochem Biophys
January 2025
Department of Pain, Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.
This study aimed to observe the mechanism of hydrogen (H) in a lung transplantation model simulated by pulmonary microvascular endothelial cells (PMVECs), which were divided into 5 groups. The blank group was the normal PMVECs. During cold ischemia period, PMVECs in the control, O, or H groups were aerated with no gas, O, or 3% H, and 3% H after transfected with a small interfering RNA targeting Nrf2 in the H+si-Nrf2 group.
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January 2025
Department of Dentistry, State University of Maringá (UEM), Maringá, Brazil.
Background: Hybrid Odontogenic Tumors (HOT) are defined by the presence of two or more independent odontogenic tumors that originate from and affect the same maxillofacial site.
Methods: The present study is the first case report of a mandibular HOT consisting of Ameloblastoma, Calcifying Epithelial Odontogenic Tumor, and Ameloblastic Fibroma.
Case Report: A 37-year-old otherwise healthy male presented with the chief complaint of swelling in the right mandibular body.
Ophthalmol Sci
November 2024
Department of Ophthalmology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Objective: To explore the association between retinal microvascular parameters and glaucoma.
Design: Prospective study.
Subjects: The UK Biobank subjects with fundus images and without a history of glaucoma.
Am J Obstet Gynecol
January 2025
Hasselt University, Faculty of Medicine and Life Sciences, Agoralaan, 3590 Diepenbeek, Belgium; Department of Obstetrics and Gynaecology, ZOL Genk, campus St. Jan, Schiepse Bos 6, 3600 Genk, Belgium.
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Study Design: For this observational study, women at high cardiovascular risk according to maternal anthropometrics, obstetric and medical history, were recruited at random gestational age depending on time of referral to the outpatient clinic for high risk prenatal care at Ziekenhuis Oost Limburg, Genk Belgium. After birth, data of maternal and neonatal outcome were obtained from the hospital records: only women with normal pregnancy (n = 142) and with preeclampsia (n = 34) were included in this analysis.
Q J Nucl Med Mol Imaging
December 2024
Nuclear Medicine, Radiology, University of Texas Southwestern, Dallas, TX, USA.
Hepatocellular carcinoma (HCC) and biliary tract cancers (BTC) pose significant diagnostic and therapeutic challenges. Magnetic resonance imaging (MRI) and multiphase computed tomography (CT) have been the preferred imaging modalities for diagnosis, staging, and surveillance of patients with these malignancies. The best clinical outcomes depend on the appropriate selection of treatment options from the tools available in neo-adjuvant therapy, surgical resection, locoregional therapy, liver transplantation, and adjuvant therapy.
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