In response to: Heise T, Nørskov M, Nosek L, Kaplan K, Famulla S and Haahr H. L. (2017) Insulin degludec: Lower day‐to‐day and within‐day variability in pharmacodynamic response compared to insulin glargine U300 in type 1 diabetes. <i>Diabetes Obes Metab</i>. 2017;19:1032–1039

Becker, R. H. A.

doi:10.1111/dom.13308

Cited by 4 publications

(3 citation statements)

References 22 publications

(79 reference statements)

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“…In 864 patients with type 2 diabetes aged 62.7 (±11.8) years, with a median followup of 3.8 years, HDL-C rather than LDL-C variability was associated with a higher risk of diabetic nephropathy progression [20]. Another study investigated the association between the variability of LDL-C, systolic blood pressure, diastolic blood pressure, and total-, HDL-and LDL-cholesterol in type 2 diabetic patients with the risk of diabetic kidney disease [21]. The study found that the combination of high variability in LDL-C and HDL-C conferred the highest risk of developing albuminuria (HR 1.47; 95% CI 1.17-1.84).…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of visit-to-visit variability, and maximum and minimum LDL cholesterol in diabetes mellitus

et al. 2022

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Background Current guidelines for dyslipidemia management recommend that the LDL-C goal be lower than 70 mg/dL. The present study investigated the prognostic significance of visit-to-visit variability in LDL-C, and minimum and maximum LDL-C during follow-up in diabetes mellitus. Methods The risk of outcomes in relation to visit-to-visit LDL-C variability was investigated in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Lipid trial. LDL-C variability indices were coefficient of variation (CV), variability independent of the mean (VIM), and average real variability (ARV). Multivariable Cox proportional hazards models were employed to estimate the adjusted hazard ratio (HR) and 95% confidence interval (CI). Results Compared with the placebo group (n=2667), the fenofibrate therapy group (n=2673) had a significantly (P<0.01) lower mean plasma triglyceride (152.5 vs. 178.6 mg/dL), and total cholesterol (158.3 vs.162.9 mg/dL) but a similar mean LDL-C during follow-up (88.2 vs. 88.6 mg/dL, P>0.05). All three variability indices were associated with primary outcome, total mortality and cardiovascular mortality both in the total population and in the fenofibrate therapy group but only with primary outcome in the placebo group. The minimum LDL-C but not the maximum during follow-up was significantly associated with various outcomes in the total population, fenofibrate therapy and placebo group. The minimum LDL-C during follow-up ≥70 mg/dL was associated with an increased risk for various outcomes. Conclusions Visit-to-visit variability in LDL-C was a strong predictor of outcomes, independent of mean LDL-C. Patients with LDL-C controlled to less than 70 mg/dL during follow-up might have a benign prognosis. ClinicalTrials.gov number: NCT 00000620.

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Section: Discussionmentioning

confidence: 99%

Prognostic significance of visit-to-visit variability, and maximum and minimum LDL cholesterol in diabetes mellitus

et al. 2022

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“…Metabolic and cardiovascular benefits of the fixed combination IdegLira were evaluated in studies DUAL and others. [79][80][81][82][83][84][85][86][87] We deemed IDegLira could be an option for T2D suffering from impaired cognitive functions. We described this condition as "cast away syndrome".…”

Section: Effects Of Fixed Combination Of Insulin Degludec and Incretimentioning

confidence: 99%

Pathophysiologic Approach to Type 2 Diabetes Management: One Centre Experience 1980–2020

Chlup¹,

Kaňa²,

Hanáčková³

et al. 2021

Type 2 Diabetes - From Pathophysiology to Cyber Systems

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This overview summarizes the evolution of pathophysiologic treatment of diabetes type 2 (T2D) in the period of the last 40 years. Randomized Controlled Trials (RCT) and Real World Evidence (RWE) studies resulted in recent Statements of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) in the year 2020. Case reports and studies of a single-centre in Czech Republic are reported. The authors demonstrate the impact of (1) multiple doses of rapid insulin, (2) multiple doses of rapid or ultrarapid insulin analogs (3) continuous subcutaneous insulin infusion (CSII) (4) incretin receptor agonists, (5) fixed combination of insulin degludec with liraglutide (IDegLira) and (6) SGLT2 inhibitor dapagliflozin, on plasma glucose concentration, HbA1c, body mass and patient satisfaction. The importance of therapeutic patients´ education and technology (personal glucometers, continuous/flash glucose monitors, insulin pens/pumps) is emphasized. Most of the observations were already published. Hence, individually adopted education, lifstyle, technical equipment, incretin receptor agonists and/or metformin and/or gliflozins and/or insulin analogs appear to be the core of an effective pathophysiologic approach. Scientific conclusions from RCTs, RWE trials and own clinical case reports may prevail over clinical inertia and induce early implementation of effective methods into routine T2D treatment.

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“…In 864 patients with type 2 diabetes aged 62.7 (±11.8) years, with a median follow-up of 3.8 years, HDL_C rather than LDL_C variability was associated with higher risk of diabetic nephropathy progression (20). Another study investigated the association between the variability of LDL_C, systolic blood pressure, diastolic blood pressure, and total-, HDLand LDL-cholesterol in Type 2 diabetic patients with the risk of diabetic kidney disease (21). The study found the combination of high variability in LDL_C and HDL-C conferred the highest risk of developing albuminuria (HR 1.47; 95% CI 1.17-1.84).…”

Section: Cardiovascular Deathsmentioning

confidence: 99%

Prognostic Significance of Visit-To-Visit Variability, Maximum and Minimum LDL Cholesterol in Diabetes Mellitus

Sheng

Miao

Ding

et al. 2021

Preprint

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BACKGROUND Current guidelines for dyslipidemia management recommended that the LDL_C goal could be lower to less than 70 mg/dL. The present study was to investigate the prognostic significance of the visit-to-visit variability in LDL_C, and minimum and maximum LDL_C during follow-up in Diabetes mellitus. METHODS We studied the risk of outcomes in relation to visit-to-visit LDL_c variability in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Lipid trial. LDL_c variability indices were coefficient of variation (CV), variability independent of the mean (VIM), and average real variability (ARV). Multivariable Cox proportional hazards models were employed to estimate adjusted hazard ratio (HR) and 95% confidence interval (CI). RESULTS Compared with the placebo group (n=2667), Fenofibrate therapy group (n=2673) had significantly (P<0.01) lower mean of plasma triglyceride (152.5 vs. 178.6 mg/dl), total cholesterol (158.3 vs.162.9 mg/dl), but similar mean LDL_C during follow-up (88.2 vs.88.6 mg/dl, P>0.05). All three variability indices were associated with primary outcome, total mortality and cardiovascular mortality both in total population and in Fenofibrate therapy group, but only with primary outcome in the placebo group. The minimum LDL_C but not the maximum during follow-up was significantly associated with various outcomes in total population, fenofibrate therapy and placebo group. The minimum LDL_C during follow-up ≥70 mg/dl was associated with increased risk for various outcomes. CONCLUSIONS Visit-to-visit variability in LDL_C was a strong predictor of outcomes, independent of mean LDL_C. Patients with LDL_C be controlled to less than 70 mg/dl at least once during follow-up might have a benign prognosis.

show abstract

In response to: Heise T, Nørskov M, Nosek L, Kaplan K, Famulla S and Haahr H. L. (2017) Insulin degludec: Lower day‐to‐day and within‐day variability in pharmacodynamic response compared to insulin glargine U300 in type 1 diabetes. Diabetes Obes Metab. 2017;19:1032–1039

Cited by 4 publications

References 22 publications

Prognostic significance of visit-to-visit variability, and maximum and minimum LDL cholesterol in diabetes mellitus

Prognostic significance of visit-to-visit variability, and maximum and minimum LDL cholesterol in diabetes mellitus

Pathophysiologic Approach to Type 2 Diabetes Management: One Centre Experience 1980–2020

Prognostic Significance of Visit-To-Visit Variability, Maximum and Minimum LDL Cholesterol in Diabetes Mellitus

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