Impact of micro‐ and macrovascular complications of type 2 diabetes on quality of life: Insights from the DISCOVER prospective cohort study

Arnold, Suzanne V.; Khunti, Kamlesh; Tang, Fengming; Chen, Hungta; Nicolucci, Antonio; Gomes, Marı́lia B.; Ji, Linong; Shestakova, Marina V.; Watada, Hirotaka; Cooper, Andrew; Fenici, Peter; Hammar, Niklas; Medina, Jesús; Kosiborod, Mikhail

doi:10.1002/edm2.321

Cited by 14 publications

(14 citation statements)

References 25 publications

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“…Chronic hyperglycemia in type 2 diabetes (T2D) leads to micro-and macrovascular complications that greatly impact the longevity, morbidity and quality of life for people with diabetes. [1][2][3] SGLT2i have consistently been shown to effectively prevent the development and progression of several diabetes complications when used as add-on treatment for T2D in high-risk individuals. [4][5][6][7][8] In the ongoing SMARTEST study, conducted in Sweden, the SGLT2i dapagliflozin is compared to metformin for treatment of early-stage T2D.…”

Section: Introductionmentioning

confidence: 99%

Health care registers can be instrumental for endpoint capture in clinical diabetes trials: example of microvascular complications in Swedish patients with type 2 diabetes

Lundqvist

Patsoukaki

Jansson

et al. 2023

Diabetes and Vascular Disease Research

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Aims SMARTEST is a register-based randomized clinical trial (RRCT) that compares dapagliflozin to metformin in early-stage type 2 diabetes. The primary outcome includes progression of microvascular complications based on data from the Swedish National Diabetes Register (NDR). In this sub-study, the aim was to validate microvascular complication variables in the NDR against electronic health records (EHRs). Methods Data were extracted from EHRs of 276 SMARTEST participants with a median observation period of 3 years in the Uppsala, Örebro and Sörmland counties and compared with NDR data. Agreement was determined for all corresponding data entries as well as for progression of microvascular complications after randomization. Results The agreement for all corresponding data entries was 98.9% (Intraclass Correlation Coefficient 0.999) for creatinine and eGFR, 95.1% for albuminuria, 91.6% for foot-at-risk and 98.2% for retinopathy status (Kappa 0.67-0.91). The agreement for progression of microvascular complications was 98.0% for CKD stage, 98.9% for albuminuria grade, 96.3% for foot-at-risk grade and 99.6% for retinopathy grade progression (Gwet’s AC1 0.96-1.00). Conclusion Microvascular complication variables in the NDR show good agreement with EHR data. The use of a well-established national health care registry, exemplified by the NDR, for endpoint collection in RRCTs such as SMARTEST is supported by this study.

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Section: Introductionmentioning

confidence: 99%

Health care registers can be instrumental for endpoint capture in clinical diabetes trials: example of microvascular complications in Swedish patients with type 2 diabetes

Lundqvist

Patsoukaki

Jansson

et al. 2023

Diabetes and Vascular Disease Research

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“…Diabetes mellitus (DM) causes various acute and chronic complications that negatively affect quality of life and threaten survival [1,2]. Emerging evidence suggests that DM is an independent risk factor for colorectal cancer (CRC).…”

Section: Introductionmentioning

confidence: 99%

Association between regular physical activity and lower incidence of colorectal cancer in patients with diabetes mellitus: a nationwide cohort study

Lee

Kim

et al. 2023

Colorectal Disease

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AimThe aim of this work was to investigate the association between changes in physical activity (PA) status and the development of colorectal cancer (CRC) in patients with diabetes.MethodThis nationwide population study included 1 439 152 patients with diabetes who underwent a health screening provided by the Korean National Health Insurance Service between January 2009 and December 2012 and a follow‐up screening after 2 years. Based on changes in PA status, participants were categorized into four groups: remained inactive, remained active, active‐to‐inactive and inactive‐to‐active.ResultsDuring the median follow‐up period of 5.2 years, 38 244 new cases of CRC were diagnosed. Compared with the remained inactive group, among the three other groups, the remained active group had the lowest risk of CRC [adjusted hazard ratio (aHR) 0.93; 95% CI 0.90–0.96], followed by the inactive‐to‐active group (aHR 0.97; 95% CI 0.94–1.00) and active‐to‐inactive group (aHR 0.99; 95% CI 0.96–1.02), after adjusting for confounding variables (p = 0.0007). This reduction in cancer incidence in the remained active group was observed for both rectal cancer (aHR 0.87, 95% CI 0.79–0.95) and colon cancer (aHR 0.93, 95% CI 0.90–0.97), irrespective of sex. In terms of the intensity and amount of PA, moderate intensity PA was the most effective, and a positive correlation was found between the amount of PA and the reduction in CRC incidence.ConclusionRegular PA was independently associated with a decreased risk of CRC in patients with diabetes. The intensity and amount of physical activity both play a role in reducing the risk.

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“…[2][3][4][5][6] Important physical burden included macrovascular (12.3%) and microvascular (18.2%) complications. 2 These diabetic complications or the new development of them resulted in increased psychological distress, worsening of quality of life, and high health costs. [2][3][4][5][6] In the United States, the costs in 2017 were $327 billion.…”

mentioning

confidence: 99%

“…2 These diabetic complications or the new development of them resulted in increased psychological distress, worsening of quality of life, and high health costs. [2][3][4][5][6] In the United States, the costs in 2017 were $327 billion. 6 The costs of myocardial infarction care and end-stage renal disease for the first year in a diabetic patient were $56 445 and $71 714, respectively.…”

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confidence: 99%

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Effects of Meditation Intervention on Self-management in Adult Patients With Type 2 Diabetes

et al. 2023

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Background Diabetes complications are prevalent and cause adverse effects on the physical, psychological, and economic status of adult patients with type 2 diabetes. Meditation may positively affect self-management and, in turn, reduce diabetes complications. However, the systematic examination of the effects of meditation without additional components on self-management in this population have been rarely examined. Purpose The aim of this study was to examine the effects of meditation interventions on self-management (ie, control of glucose, blood pressure, cholesterol, and obesity and self-management) among adult patients with type 2 diabetes in randomized controlled trials. Methods In this systematic review and meta-analysis, 6 electronic databases were searched using major keywords of meditation, diabetes, and self-management during March 2022. Results Eight studies (9 articles) using mindfulness-based meditation were included. The meta-analysis showed that meditation improved hemoglobin A1c (effect size = −0.75; 95% confidence interval, −1.30 to −0.21; P = .007) but not fasting blood glucose. Only a few studies examined meditation effects on other types of self-management (eg, blood pressure, body mass index, cholesterol, diet, exercise, foot care, and monitoring of blood glucose), and the effects were inconsistent. In 1 study, meditation improved diabetes self-management. Conclusions Mindfulness-based meditation reduced hemoglobin A1c levels in adult patients with type 2 diabetes but did not consistently improve other types of self-management in a few studies examined. This may imply the need for additional intervention components to improve different types of self-management. Further studies are needed to examine the effects of different types of meditations with additional components on different types of self-management.

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Impact of micro‐ and macrovascular complications of type 2 diabetes on quality of life: Insights from the DISCOVER prospective cohort study

Abstract: This is an open access article under the terms of the Creat ive Commo ns Attri bution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 14 publications

References 25 publications

Health care registers can be instrumental for endpoint capture in clinical diabetes trials: example of microvascular complications in Swedish patients with type 2 diabetes

Health care registers can be instrumental for endpoint capture in clinical diabetes trials: example of microvascular complications in Swedish patients with type 2 diabetes

Association between regular physical activity and lower incidence of colorectal cancer in patients with diabetes mellitus: a nationwide cohort study

Effects of Meditation Intervention on Self-management in Adult Patients With Type 2 Diabetes

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