scholarly journals Analyzing the Factors Contributing to Withdrawal from Insulin Therapy following Additional Administration of Alogliptin: Retrospective Study after Removing Glucotoxicity with Insulin

2015 ◽  
Vol 6 ◽  
pp. JCM.S27202
Author(s):  
Hiromi Hamamoto ◽  
Koji Nakanishi ◽  
Mitsuhiko Noda
Keyword(s):  
Type 2 Diabetes ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Retrospective Study ◽  
Insulin Therapy ◽  
Logistic Regression Analysis ◽  
Insulin Dose ◽  
Contributing Factors ◽  
Hba1c Levels

We attempted to examine whether withdrawal from insulin therapy is or is not possible with administration of additional alogliptin and identify the contributing factors. The subjects were 43 adult patients with type 2 diabetes undergoing insulin therapy after admission. After glucotoxicity was removed, 25 mg alogliptin was additionally administered. Insulin was reduced by 15.6 ± 13.0 units (mean ± SD), and 17 patients (39.5%) completely withdrew from insulin therapy. Several factors were compared between the two groups of patients: those who could withdraw from insulin therapy and those who could not. The former group showed lower HbA1c levels on admission, a lower insulin dose before adding alogliptin, lower injection frequencies, and longer treatment histories prior to admission. Logistic regression analysis showed that lower insulin dose contributed significantly to withdrawal. These results suggest that a lower insulin dose is the best predictor for withdrawal from insulin therapy after adding alogliptin.

scholarly journals Association of Postbreakfast Triglyceride and Visit-to-Visit Annual Variation of Fasting Plasma Glucose with Progression of Diabetic Nephropathy in Patients with Type 2 Diabetes

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Kaori Kitaoka ◽  
Akiko Takenouchi ◽  
Ayaka Tsuboi ◽  
Keisuke Fukuo ◽  
Tsutomu Kazumi
Keyword(s):  
Type 2 Diabetes ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Plasma Glucose ◽  
Multivariate Logistic Regression Analysis ◽  
Lipid Lowering ◽  
Diabetic Patients ◽  
Multivariate Logistic Regression

Urinary albumin/creatinine ratio (ACR) was measured at baseline and after a median follow-up of 6.0 years in 161 patients with type 2 diabetes. Intrapersonal means and SD of HbA1c, systolic BP, fasting, and postmeal plasma glucose (FPG and PMPG, resp.) and serum triglycerides (FTG and PMTG, resp.) were calculated in each patient during the first 12 months after enrollment. Associations of these variables with nephropathy progression (15 patients with progression of albuminuric stages and 5 with ACR doubling within the microalbuminuric range) were determined by multivariate logistic regression analysis providing odds ratio with 95% confidential interval. Patients with nephropathy progression, compared with those without nephropathy progression, had higher HbA1c (p<0.01). They also had higher means and SD of FPG (bothp<0.05), FTG (bothp<0.05), and PMTG (p=0.001). Multivariate logistic regression analysis demonstrated that SD-FPG (1.036, 1.001–1.073,p=0.04) and PMTG (1.013, 1.008–1.040,p=0.001) were significant predictors of progression of nephropathy even after adjustment for mean FPG and SD-FTG, age, sex, BMI, waist circumference, diabetes duration and therapy, means and SDs of HbA1c, PPG, FTG and systolic BP, baseline ACR, smoking status, and uses of antihypertensive and lipid-lowering medications. Consistency of glycemic control and management of postmeal TG may be important to prevent nephropathy progression in type 2 diabetic patients.

The association between hypoglycemia and glycemic variability in elderly patients with type 2 diabetes: cross-sectional study

2020 ◽  
Author(s):  
Takahisa Handa ◽  
Akinobu Nakamura ◽  
Aika Miya ◽  
Hiroshi Nomoto ◽  
Hiraku Kameda ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Elderly Patients ◽  
Logistic Regression Analysis ◽  
Roc Curve ◽  
Multivariate Logistic Regression Analysis ◽  
Glycemic Variability ◽  
Multivariate Logistic Regression

Abstract BackgroundThis study aimed to explore predictive factors of time below target glucose range (TBR) ≥ 1% among patients’ characteristics and glycemic variability (GV) indices using continuous glucose monitoring data in elderly patients with type 2 diabetes.MethodsWe conducted a prospective observational study on 179 (71 female) Japanese outpatients with type 2 diabetes aged ≥ 65 years. The characteristics of the participants with TBR ≥ 1% were evaluated by multivariate logistic regression analysis. Receiver-operating characteristic (ROC) curve analyses of GV indices, comprising coefficient of variation (CV), standard deviation, and mean amplitude of glycemic excursions, were performed to identify the optimal index for the identification of patients with TBR ≥ 1%.ResultsIn the multivariate logistic regression analysis, none of the clinical characteristics, including HbA1c and C-peptide index, were independent markers for TBR ≥ 1%, while all three GV indices showed significant associations with TBR ≥ 1%. Among the three GV indices, CV showed the best performance based on the area under the curve in the ROC curve analyses.ConclusionsAmong elderly patients with type 2 diabetes, CV reflected TBR ≥ 1% most appropriately among the GV indices examined.Trial registration: UMIN-CTR: UMIN000029993. Registered 16 November 2017

scholarly journals DPP4 inhibitors as a risk factor for QTC interval prolongation among type 2 diabetic patients

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
R J Enero ◽  
J Amora
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Tertiary Hospital ◽  
Qtc Interval ◽  
Dpp4 Inhibitors ◽  
Independent Risk Factors

Abstract Introduction Prolonged QT interval is associated with cardiac arrhythmias and sudden death. This study determined the prevalence of QT intervals corrected for heart rate (QTc) among adults admitted for executive check up in a tertiary hospital with Type 2 diabetes and its associations with metabolic control. Methods This cross-sectional study included 111 adult patients with Type 2 diabetes and 152 control patients admitted for executive check up in a tertiary hospital. A standard 12-lead electrocardiogram was recorded. Corrected QT interval (QTc) of &gt;440 ms was considered abnormally prolonged and QTc &gt;500 ms was considered a high-risk QTc. Demographic, clinical and laboratory data were collected. Independent risk factors for prolonged QTc were assessed using logistic regression analysis. Results QTc duration was statistically significant between subjects with Type 2 diabetes and control subjects (mean duration 434 vs 419 ms; P=0.003). Prevalence of prolonged QTc among type 2 diabetics is 41.4% and 28% in the control group. In the diabetic group 2.7% has a QTc of &gt;500. Independent risk factors for prolonged QTc using univariate logistic regression analysis is presence of diabetes type 2 (OR = 2.00, p=0.008), HBA1c (OR = 1.23, p=0.050) and intake of DPP4 (OR=6.46, (p≤0.001). Independent risk factors for prolonged QTc using multivariate logistic regression analysis is intake of DPP4 inhibitors (OR=6.26, p=0.023). Conclusion There is no significant correlation between HBA1C and QTc interval. The prevalence of prolonged QTc is relatively high among diabetics but the prevalence of high risk QTc interval is relatively low. Intake of DPP4 inhibitors is an independent risk factor in QT prolongation. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals The association between hypoglycemia and glycemic variability in elderly patients with type 2 diabetes: a prospective observational study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Takahisa Handa ◽  
Akinobu Nakamura ◽  
Aika Miya ◽  
Hiroshi Nomoto ◽  
Hiraku Kameda ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Observational Study ◽  
Elderly Patients ◽  
Prospective Observational Study ◽  
Multivariate Logistic Regression Analysis ◽  
Glycemic Variability ◽  
Multivariate Logistic Regression

Abstract Background This study aimed to explore predictive factors of time below target glucose range (TBR) ≥ 1% among patients’ characteristics and glycemic variability (GV) indices using continuous glucose monitoring data in elderly patients with type 2 diabetes. Methods We conducted a prospective observational study on 179 (71 female) Japanese outpatients with type 2 diabetes aged ≥ 65 years. The characteristics of the participants with TBR ≥ 1% were evaluated by multivariate logistic regression analysis. Receiver-operating characteristic (ROC) curve analyses of GV indices, comprising coefficient of variation (CV), standard deviation, and mean amplitude of glycemic excursions, were performed to identify the optimal index for the identification of patients with TBR ≥ 1%. Results In the multivariate logistic regression analysis, none of the clinical characteristics, including HbA1c and C-peptide index, were independent markers for TBR ≥ 1%, while all three GV indices showed significant associations with TBR ≥ 1%. Among the three GV indices, CV showed the best performance based on the area under the curve in the ROC curve analyses. Conclusions Among elderly patients with type 2 diabetes, CV reflected TBR ≥ 1% most appropriately among the GV indices examined. Trial registration UMIN-CTR: UMIN000029993. Registered 16 November 2017

Insulin Dosage Adjustments After Initiation of GLP-1 Receptor Agonists in Patients With Type 2 Diabetes

2021 ◽  
pp. 089719002199362
Author(s):  
Mandy Chen ◽  
Etty Vider ◽  
Roda Plakogiannis
Keyword(s):  
Type 2 Diabetes ◽  
Body Weight ◽  
Insulin Therapy ◽  
Basal Insulin ◽  
Insulin Dose ◽  
Retrospective Chart Review ◽  
Insulin Dosage ◽  
History Of ◽  
Bolus Insulin

Background: Combination of insulin and GLP-1RAs have shown reductions in the HbA1c, body weight, and the risk of hypoglycemia. To date, there are conflicting data regarding the effect of GLP-1RAs on insulin dosage(s). Objective: The objective of this study was to evaluate adjustments of insulin doses upon initiation of GLP-1RAs. Methods: This was a retrospective chart review of patients on insulin therapy initiated on GLP-1RAs at NYU Langone Health. Patients were included in the study if they were at least 18 years of age, history of type 2 diabetes, and were on concurrent basal or mixed insulin therapy. 45 patients met inclusion criteria and were included in the study analysis. The primary endpoint was the median change in overall basal insulin doses. Secondary endpoints included median changes in total basal, mixed, and bolus insulin doses, oral antidiabetic medications and GLP-1RA doses, HbA1c, body weight, fasting glucose, and creatinine clearance. Safety results included any adverse reactions to insulin and/or GLP-1RA. Results: In the per-protocol analysis, there was a significant reduction in overall total basal insulin doses from baseline to week 24 (50 units vs. 44 units, p < 0.05). There was a median reduction in patients receiving glargine (50 units vs. 44 units) and detemir (29 units vs. 21.5 units). Conclusions: Use of GLP-1RAs after 24 weeks resulted in a statistically significant reduction in overall total basal insulin dosages from baseline. The median HbA1C in our patient population was >8%. Consider a ≥10% reduction in the overall basal insulin dose upon initiation of GLP-1RA in patients with a HbA1C >8%.

scholarly journals Risk Factors of Atrial Arrhythmia in Patients With Liver Cirrhosis: A Retrospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiya Lu ◽  
Zhijing Wang ◽  
Liu Yang ◽  
Changqing Yang ◽  
Meiyi Song
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Liver Cirrhosis ◽  
Retrospective Study ◽  
Logistic Regression Analysis ◽  
Multiple Logistic Regression Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Clinical Information ◽  
Atrial Arrhythmia

Background and Objectives: Liver cirrhosis is known to be associated with atrial arrhythmia. However, the risk factors for atrial arrhythmia in patients with liver cirrhosis remain unclear. This retrospective study aimed to investigate the risk factors for atrial arrhythmia in patients with liver cirrhosis.Methods: In the present study, we collected data from 135 patients with liver cirrhosis who were admitted to the Department of Gastroenterology at Shanghai Tongji Hospital. We examined the clinical information recorded, with the aim of identifying the risk factors for atrial arrhythmia in patients with liver cirrhosis. Multiple logistic regression analysis was used to screen for significant factors differentiating liver cirrhosis patients with atrial arrhythmia from those without atrial arrhythmia.Results: The data showed that there were seven significantly different factors that distinguished the group with atrial arrhythmia from the group without atrial arrhythmia. The seven factors were age, white blood cell count (WBC), albumin (ALB), serum Na+, B-type natriuretic peptide (BNP), ascites, and Child-Pugh score. The results of multivariate logistic regression analysis suggested that age (β = 0.094, OR = 1.098, 95% CI 1.039–1.161, P = 0.001) and ascites (β =1.354, OR = 3.874, 95% CI 1.202–12.483, P = 0.023) were significantly associated with atrial arrhythmia.Conclusion: In the present study, age and ascites were confirmed to be risk factors associated with atrial arrhythmia in patients with liver cirrhosis.

scholarly journals Factors associated with depression in the patients with diabetes mellitus type 2

2019 ◽  
Vol 76 (11) ◽  
pp. 1178-1183 ◽  
Author(s):  
Admir Sabanovic ◽  
Natasa Maksimovic ◽  
Mirjana Stojanovic-Tasic ◽  
Marijan Bakic ◽  
Anita Grgurevic
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Diabetes Mellitus Type 2 ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Factors Associated

Background/Aim. The assessment of association of depression and diabetes mellitus type 2 using the Patient Health Questionaire (PHQ-9) has not been done in Montenegro. The aim of this study was to assess the prevalence of depression in the patients with type 2 diabetes mellitus, and to identify the risk factors associated with the presence of depression. Methods. A cross-sectional study was conducted at the General Hospital in Bijelo Polje, from July to September, 2015. It included 70 patients over 35 years of age with the diagnosis of diabetes for at least six months. For the assessment of depression presence and intensity PHQ?9 was used. All variables associated with the presence of depression at a significance level of p < 0.05 were included into the final method of the multivariate logistic regression analysis. Results. Comorbidities were statistically significant more frequent among patients with depression (?2 = 5.40; p = 0.020). Duration of diabetes over five years was significantly associated with depression (?2 = 12.48; p < 0.001). Depression occurred more frequently among physically inactive subjects (?2 = 10.74; p = 0.005). The presence of diabetic polyneuropathy (?2 = 6.04; p = 0.014) and cataract (?2 = 5.351; p = 0.021) were also significantly associated with depression. A multivariate logistic regression analysis showed that the duration of diabetes over five years and presence of cataract were independently associated with depression. Conclusion. The risk factors for depression among the subjects with diabetes were disease duration more than five years and the presence of cataract. Since depression is a serious disease and can be a risk factor for many chronic diseases, the best way of prevention is its early detection and treatment.

“Non-Hodgkin's Lymphomas and Diabetes of Type 2 in Elderly Patients: Impact On Management in the Real Life”.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4998-4998
Author(s):  
Stephane Moreau ◽  
Liliane Remenieras ◽  
Mohamed Touati ◽  
Marie Jose RAPP ◽  
Marie-Pierre Gourin ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Logistic Regression ◽  
Multivariate Analysis ◽  
Regression Analysis ◽  
Regional Network ◽  
Diabetes Status ◽  
Significant Difference ◽  
Dose Reductions

Abstract Abstract 4998 Purpose Prevalence of patients (pts) suffering of non-Hodgkin's lymphoma (NHL) and diabetes is increasing. Previous investigations were mainly focused on possible association with an increased risk of NHL in pts with type 2 diabetes. In another way, it is well known that NHL patients (pts) with co-morbidity are treated less intensively and have worse prognosis. We propose a retrospective analysis of a homogeneous aggressive lymphoma cohort based on a multicentric regional network database to assess the cross-impact of diabetes and NHL in term of pts management and survival. Patients and methods All pts with high-grade NHL cases, histologically proven, diagnosed between 2003 and 2008 in the Hematology Department of regional network HEMATOLIM, have been included. Diabetes of type 2 has been defined according to international criteria. Data about diabetes and lymphoma treatments, toxicity, relapse, progression or death, have been collected from the Database Structure Régionale de Référence sur les Lymphomes en Limousin. Statistical analysis had been done by StatView and SAS 9.1.2 softwares. Results We included 251 NHL pts with aggressive NHL concerning 69.3% Diffuse Large B Cell Lymphoma (DLBCL) (n=174), 7.6% Mantle cell (n=19), 5.2% Peripheral T-cell (n=13), 5.2% Burkitt (n=13) and 12.7% others (anaplastic (n=9), Follicular grade 3B (n=8),T angioimmunoblastic (n=8), primary mediastinal NHL (n=3), nasal NK-T (n=2), T-cell-rich BCL (n=1), centroblastic BCL (n=1)). Among these NHL, 16.7% had type 2 diabetes (n=42). Sex ratio was 1 for diabetic pts (dp) versus (vs) 1.4 for non-diabetic pts (ndp), the average age was 65.1±15.8, 71.3±8.4 for dp vs 63.8±16.6 for ndp (p=0.005). All received first-line chemotherapy mainly Cyclophosphamide/Oncovin/ Adriamycine/Prednisone ± Rituximab (54.6%, n=137), with no difference between dp and ndp (respectively 59.5% vs 57.0%). Chemo-resistance was reported for 22.7% of pts (28.6% dp (n=12) and 21.5% ndp (n=45)). Chemotherapy-related toxicities were more frequent in dp (71.4%, n=30, vs 47.8%, n=100 ndp) (p=0.005), mainly fever and/or bleeding and infectious complications or back to hospitalization. Dose reductions were more frequent in dp, 31.0%, (n=13) vs ndp 12.0%, n=25) (p=0.0017) and adjustements in time-interval (54.8%, n=23, vs 38.8%, n=81 ndp) (p=0.05) of chemotherapy course. A logistic regression analysis showed that dose reductions and treatment-related toxicities were associated to diabetes status (p=0.015 and p=0.026, respectively). Complete remission (CR) was achieved for 66% ndp (n=138) vs 40.5% dp (n=17) with significant difference (p=0.0019). Relapses: no significant difference between both groups with 13.9% ndp (n=29) vs 19% dp (n=8). Mortality rate was significantly increased: 41.6 % ndp vs 59.5% dp (p=0.033), mainly due to NHL complications, 41.6% ndp (n=87) vs 59.5% dp (n=25) (p=0.033). With a median follow-up of 17 months (m) (range 0-72), median overall survival (OS) was not reached for ndp vs 12±9 m for dp (p=0.006), median event-free survival (EFS) was 41±6.2 m for ndp vs 11±4.3 m for dp (p=0.002). In a multivariate analysis, the differences disappeared on OS and EFS after adjustment on age. A logistic regression analysis showed an important increasing of complications, adjustment of doses, and CR but these chemotherapy-related toxicities had no impact on dp survival. The impact of chemotherapy mainly including corticosteroids on the long term diabetes status has been assessed at the end of NHL treatment, 35.7% increased oral medication to oral insulin or received an intensified dose of the antidiabetic treatment (9.5%, n=4). Some dp with oral treatment improved their glycemia (7.1%, n=3), and used only hygiene-dietary measures. Long term insulin treatment was introduced after glycemia disorders for 3.8% ndp (n=8). Conclusion Aggressive NHL were more frequently associated with type 2 diabetes (16%) in our regional cohort probably due to the study population median age around 68 years. A real impact of incidence of the chemotherapy-related toxicities, back to hospitalization, a less dose-intensity chemotherapy on dp CR has been significantly demonstrated. EFS and OS were not significant in multivariate analysis especially with adjustment on age. These results claim for a cautious management of diabetes at the initial assessment and during chemotherapy for decreasing complications and by an intensive patient education. Disclosures No relevant conflicts of interest to declare.

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