Depressive Symptoms and All‐Cause Mortality in Older American Indians with Type 2 Diabetes Mellitus

2019 ◽  
Vol 67 (9) ◽  
pp. 1940-1945 ◽  
Author(s):  
R. Turner Goins ◽  
Carolyn Noonan ◽  
Blythe Winchester ◽  
David Brock
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Depressive Symptoms ◽  
American Indians ◽  
All Cause Mortality

scholarly journals Comparative effects of sodium glucose cotransporter 2 (SGLT2) inhibitors and dipeptidyl peptidase-4 (DPP4) inhibitors on new-onset atrial fibrillation and stroke outcomes

2021 ◽  
Author(s):  
Sharen Lee ◽  
Jiandong Zhou ◽  
Carlin Chang ◽  
Tong Liu ◽  
Dong Chang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Atrial Fibrillation ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Propensity Score ◽  
Lower Risk ◽  
Sglt2 Inhibitors ◽  
All Cause Mortality ◽  
New Onset

AbstractBackgroundSGLT2I and DPP4I are medications prescribed for type 2 diabetes mellitus patients. However, there are few population-based studies comparing their effects on incident atrial fibrillation or ischemic stroke.MethodsThis was a territory-wide cohort study of type 2 diabetes mellitus patients prescribed SGLT2I or DPP4I between January 1st, 2015 to December 31st, 2019 in Hong Kong. Patients with both DPP4I and SGLT2I use and patients with drug discontinuation were excluded. Patients with prior AF or stroke were excluded for the respective analysis. 1:2 propensity-score matching was conducted for demographics, past comorbidities and medications using nearest-neighbor matching method. Cox models were used to identify significant predictors for new onset heart failure (HF) or myocardial infarction (MI), cardiovascular and all-cause mortality.ResultsThe AF-free cohort included 49108 patients (mean age: 66.48 years old [SD: 12.89], 55.32% males) and the stroke-free cohort included 49563 patients (27244 males [54.96%], mean baseline age: 66.7 years old [SD: 12.97, max: 104.6 years old]). After propensity score matching, SGLT2i use was associated with a lower risk of new onset AF (HR: 0.43[0.28, 0.66]), cardiovascular mortality (HR: 0.79[0.58, 1.09]) and all-cause mortality (HR: 0.69[0.60, 0.79]) in the AF-free cohort. It was also associated with a lower risk of new onset stroke (0.46[0.33, 0.64]), cardiovascular mortality (HR: 0.74[0.55, 1.00]) and all-cause mortality (HR: 0.64[0.56, 0.74]) in the stroke-free cohort.ConclusionsThe novelty of our work si that SGLT2 inhibitors are protective against atrial fibrillation and stroke development for the first time. These findings should be validated in other cohorts.

scholarly journals Prevalence of Depressive Symptoms in the Elderly Population Diagnosed with Type 2 Diabetes Mellitus

2020 ◽  
Vol 17 (10) ◽  
pp. 3553
Author(s):  
Beata Dziedzic ◽  
Zofia Sienkiewicz ◽  
Anna Leńczuk-Gruba ◽  
Ewa Kobos ◽  
Wiesław Fidecki ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Depressive Symptoms ◽  
Outpatient Clinic ◽  
Elderly Population ◽  
The Elderly ◽  
Screening Tests ◽  
Significant Difference

Introduction: A sharp rise in the population of elderly people, who are more prone to somatic and mental diseases, combined with the high prevalence of type 2 diabetes mellitus and diabetes-associated complications in this age group, have an impact on the prevalence of depressive symptoms. Aim of the work: The work of the study was the evaluation of the prevalence of depressive symptoms in the elderly population diagnosed with type 2 diabetes mellitus. Materials and methods: The pilot study was conducted in 2019 among 200 people diagnosed with type 2 diabetes mellitus, aged 65 years and above, receiving treatment in a specialist diabetes outpatient clinic. The study was based on a questionnaire aimed at collecting basic sociodemographic and clinical data and the complete geriatric depression scale (GDS, by Yesavage) consisting of 30 questions. Results: The study involved 200 patients receiving treatment in a diabetes outpatient clinic. The mean age of the study subjects was 71.4 ± 5.0 years. The vast majority of the subjects (122; 61%) were women, with men accounting for 39% of the study population (78 subjects). A statistically significant difference in the GDS (p < 0.01) was shown for marital status, body mass index (BMI), duration of diabetes, and the number of comorbidities. Patients with results indicative of symptoms of mild and severe depression were found to have higher BMI, longer disease duration, and a greater number of comorbidities. There were no statistically significant differences in the level of HbA1c. Conclusions: In order to verify the presence of depressive symptoms in the group of geriatric patients with diabetes mellitus, an appropriate screening programme must be introduced to identify those at risk and refer them to specialists, so that treatment can be promptly initiated. Screening tests conducted by nurses might help with patient identification.

scholarly journals Cardiovascular and all-cause mortality in patients with type 2 diabetes mellitus in the MADIABETES Cohort Study: Association with chronic kidney disease

2016 ◽  
Vol 30 (2) ◽  
pp. 227-236 ◽  
Author(s):  
Miguel Ángel Salinero-Fort ◽  
Francisco Javier San Andrés-Rebollo ◽  
Carmen de Burgos-Lunar ◽  
Juan Carlos Abánades-Herranz ◽  
Enrique Carrillo-de-Santa-Pau ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Type 2 Diabetes Mellitus ◽  
Cohort Study ◽  
Kidney Disease ◽  
All Cause Mortality ◽  
Study Association

scholarly journals Association of sex hormone-binding globulin and free testosterone with mortality in men with type 2 diabetes mellitus

2016 ◽  
Vol 174 (1) ◽  
pp. 59-68 ◽  
Author(s):  
Aye N Tint ◽  
Rudolf Hoermann ◽  
Henry Wong ◽  
Elif I Ekinci ◽  
Richard J MacIsaac ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Free Testosterone ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Inverse Association ◽  
Hormone Binding ◽  
All Cause Mortality

ObjectiveLow circulating testosterone levels have been associated with increased mortality in men. We hypothesized that the prognostic role of testosterone in men with type 2 diabetes mellitus (T2DM) is influenced by its carrier protein sex hormone-binding globulin (SHBG).DesignWe conducted a prospective cohort study at a tertiary referral centre.MethodsIn total, 531 men with T2DM presenting to a diabetes clinic in 2004–2005 were followed prospectively until death, or July 31, 2014, and a survival analysis was performed. The main outcome measure was all cause mortality.ResultsOver a mean (s.d.) follow up of 7.6 years (2.6) 175 men (33%) died. In Cox proportional hazard models both higher SHBG (Hazard Ratio (HR) 1.012 (95% CI 1.002–1.022), P=0.02) and lower calculated free testosterone (cFT) (HR 0.995 (95% CI 0.993–0.998), P=0.001) were risk factors for all cause mortality independently of age, BMI, presence of macro- and microvascular disease, duration of T2DM, hemoglobin, renal function, insulin use, C-reactive protein and homeostatic model of insulin resistance. By contrast, the inverse association of total testosterone (TT) with mortality weakened after these adjustments (P=0.11). SHBG remained associated with mortality (P<0.001) both if substituted for or added to TT in the multivariable model. In the fully adjusted model, an increase of SHBG by 17.3 nmol/l (1 s.d.) increased mortality by 22% and a decrease in cFT by 81 pmol/l (1 s.d.) increased mortality by 45%.ConclusionsThe association of SHBG with mortality in men with T2DM is novel. Whether SHBG acts via regulation of testosterone, has intrinsic biological roles, or is a marker of poor health requires further study.

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