Differences between Western and Asian type 2 diabetes patients in the incidence of vascular complications and mortality: A systematic review of randomized controlled trials on lowering blood glucose

Li, Jing; Dong, Yajie; Wu, Taixiang; Tong, Nanwei

doi:10.1111/1753-0407.12361

Cited by 22 publications

(25 citation statements)

References 24 publications

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“…Firstly, compared with their Western counterparts, Asian individuals might have a different pattern for complications of diabetes 42. A meta-analysis of interventional randomised controlled trials showed that the risk of microvascular events and new or worsening nephropathy was significantly higher in Asian patients than in western patients 43. In our analysis, the risk of macrovascular disease (composite cardiovascular disease, coronary heart disease, and stroke) associated with prediabetes was similar in Asian and non-Asian patients.…”

Section: Discussionmentioning

confidence: 58%

“…Secondly, differences in genetics, socioeconomic factors, and treatment approaches for atherosclerotic cardiovascular disease between Asia and other continents might also have a role in the influence of prediabetes on mortality in Asia 4346. Based on these results, prediabetes management programmes, tailored to Asian patients with atherosclerotic cardiovascular disease, might be clinically important, and these programmes should be investigated in future studies.…”

Section: Discussionmentioning

confidence: 99%

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Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis

Cai

Zhang

et al. 2020

BMJ

434

311

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Objective To evaluate the associations between prediabetes and the risk of all cause mortality and incident cardiovascular disease in the general population and in patients with a history of atherosclerotic cardiovascular disease. Design Updated meta-analysis. Data sources Electronic databases (PubMed, Embase, and Google Scholar) up to 25 April 2020. Review methods Prospective cohort studies or post hoc analysis of clinical trials were included for analysis if they reported adjusted relative risks, odds ratios, or hazard ratios of all cause mortality or cardiovascular disease for prediabetes compared with normoglycaemia. Data were extracted independently by two investigators. Random effects models were used to calculate the relative risks and 95% confidence intervals. The primary outcomes were all cause mortality and composite cardiovascular disease. The secondary outcomes were the risk of coronary heart disease and stroke. Results A total of 129 studies were included, involving 10 069 955 individuals for analysis. In the general population, prediabetes was associated with an increased risk of all cause mortality (relative risk 1.13, 95% confidence interval 1.10 to 1.17), composite cardiovascular disease (1.15, 1.11 to 1.18), coronary heart disease (1.16, 1.11 to 1.21), and stroke (1.14, 1.08 to 1.20) in a median follow-up time of 9.8 years. Compared with normoglycaemia, the absolute risk difference in prediabetes for all cause mortality, composite cardiovascular disease, coronary heart disease, and stroke was 7.36 (95% confidence interval 9.59 to 12.51), 8.75 (6.41 to 10.49), 6.59 (4.53 to 8.65), and 3.68 (2.10 to 5.26) per 10 000 person years, respectively. Impaired glucose tolerance carried a higher risk of all cause mortality, coronary heart disease, and stroke than impaired fasting glucose. In patients with atherosclerotic cardiovascular disease, prediabetes was associated with an increased risk of all cause mortality (relative risk 1.36, 95% confidence interval 1.21 to 1.54), composite cardiovascular disease (1.37, 1.23 to 1.53), and coronary heart disease (1.15, 1.02 to 1.29) in a median follow-up time of 3.2 years, but no difference was seen for the risk of stroke (1.05, 0.81 to 1.36). Compared with normoglycaemia, in patients with atherosclerotic cardiovascular disease, the absolute risk difference in prediabetes for all cause mortality, composite cardiovascular disease, coronary heart disease, and stroke was 66.19 (95% confidence interval 38.60 to 99.25), 189.77 (117.97 to 271.84), 40.62 (5.42 to 78.53), and 8.54 (32.43 to 61.45) per 10 000 person years, respectively. No significant heterogeneity was found for the risk of all outcomes seen for the different definitions of prediabetes in patients with atherosclerotic cardiovascular disease (all P>0.10). Conclusions Results indicated that prediabetes was associated with an increased risk of all cause mortality and cardiovascular disease in the general population and in patients with atherosclerotic cardiovascular disease. Screening and appropriate management of prediabetes might contribute to primary and secondary prevention of cardiovascular disease.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis

Cai

Zhang

et al. 2020

BMJ

434

311

View full text Add to dashboard Cite

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“…There are differences on weight outcomes and weight gain liabilities on FEP patients from Western countries as opposed to patients from Asian countries (Tek et al, 2016). Previous studies has also shown differences in prevalence of type II diabetes and in glucose metabolism outcomes between different ethnicities (Li, Dong, Wu, & Tong, 2016;Whiting, Guariguata, Weil, & Shaw, 2011). Therefore, we also performed a sub-group analysis to compare glucose metabolism outcomes between different regions (Asian vs non-Asian).…”

Section: Statistical Analysesmentioning

confidence: 99%

Glucose metabolism dysregulation at the onset of mental illness is not limited to first episode psychosis: A systematic review and meta‐analysis

Küçükgöncü

Košir

Zhou

et al. 2018

Early Intervention Psych

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Aim: To compare the differences of glucose metabolism outcomes between treatment-naïve, patients with first episode psychosis (FEP) and mood disorders.Methods: We conducted a systematic review and meta-analysis of glucose intolerance in treatment-naïve, first episode patients with severe mental illnesses (SMIs). Results:We identified 31 eligible studies. Compared to healthy controls, FEP group have higher insulin and insulin resistance levels, and both groups have higher glucose tolerance test results.No significant differences were found in glucose metabolism outcomes between FEP and mood disorder groups.Conclusions: Our results highlight impaired glucose metabolism at the onset of SMIs, suggesting both patients with psychosis and mood disorders are high-risk groups for diabetes development. K E Y W O R D Sdiabetes, first episode, insulin, mood disorders, psychosis

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“…Differences in BG profiles among patients with T2DM of different races and ethnicities may have implications for how T2DM is managed and for treatment outcomes. Patients in Asia have earlier onset and longer duration of T2DM and are at a higher risk of microvascular complications, particularly renal disease, compared with Caucasians . Analysis of BG profiles among Caucasian patients with T2DM who were insulin‐naive has shown that the contribution of postprandial BG to excess hyperglycemia decreases relative to fasting BG in poorly controlled patients .…”

Section: Discussionmentioning

confidence: 99%

Blood glucose profiles in East Asian and Caucasian injection‐naive patients with type 2 diabetes inadequately controlled on oral medication: a pooled analysis

Zhang

Hou

et al. 2018

Diabetes Metabolism Res

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Differences between Western and Asian type 2 diabetes patients in the incidence of vascular complications and mortality: A systematic review of randomized controlled trials on lowering blood glucose

Abstract: Background: Differences exist between Western and Asian people with type 2 diabetes (T2D). The aim of the present systematic review was to determine whether there are differences in chronic diabetic vascular complications (CDVCs) and mortality between Western and Asian patients with T2D.

Cited by 22 publications

References 24 publications

Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis

Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis

Glucose metabolism dysregulation at the onset of mental illness is not limited to first episode psychosis: A systematic review and meta‐analysis

Blood glucose profiles in East Asian and Caucasian injection‐naive patients with type 2 diabetes inadequately controlled on oral medication: a pooled analysis

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