Retinopathy in Older Type II Diabetics Association With Glucose Control

Nathan, David M.; Singer, Daniel E.; Godine, John E.; Harrington, Catherine Hodgson; Perlmuter, Lawrence C.

doi:10.2337/diab.35.7.797

Cited by 107 publications

(36 citation statements)

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“…To test for trend, the 3 categories were entered in the model as an ordinal variable. We used multiple logistic regression analysis to control for potential confounders, ie, age, sex, glucose tolerance category, known duration of DM of more than 10 years (in the present study a duration effect was seen after 10 years, which is in agreement with other studies 2,5,28 ), HbA 1c level, and hypertension. To exclude the possibility of residual confounding as thoroughly as possible, we also tested models that, in addition, included serum creatinine level, creatinine clearance, hypercholesterolemia, current smoking, body mass index, and/or fasting insulin level.…”

Section: Discussionsupporting

confidence: 77%

Hyperhomocysteinemia Is Associated With the Presence of Retinopathy in Type 2 Diabetes Mellitus

Hoogeveen¹,

Kostense²,

Eysink³

et al. 2000

Arch Intern Med

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Section: Discussionsupporting

confidence: 77%

Hyperhomocysteinemia Is Associated With the Presence of Retinopathy in Type 2 Diabetes Mellitus

Hoogeveen¹,

Kostense²,

Eysink³

et al. 2000

Arch Intern Med

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“…Age is associated with reduction in renal function,21 and together with potentially longer duration of diabetes, older patients are likely to be at increased risk of microvascular complications22 including renal impairment and other co‐morbidities 23…”

Section: Discussionmentioning

confidence: 99%

A randomized clinical trial of the efficacy and safety of sitagliptin compared with dapagliflozin in patients with type 2 diabetes mellitus and mild renal insufficiency: The CompoSIT‐R study

Scott

Morgan

Zimmer

et al. 2018

Diabetes Obesity Metabolism

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AimTo compare the efficacy and safety of the dipeptidyl peptidase‐4 inhibitor sitagliptin with the sodium‐glucose transporter‐2 inhibitor dapagliflozin in patients with type 2 diabetes and mild renal insufficiency.Materials and MethodsPatients with HbA1c ≥7.0 to ≤9.5% (≥53 to ≤80 mmol/mol) and estimated glomerular filtration rate ≥60 to <90 mL/min/1.73m2 on metformin (≥1500 mg/d) ± sulfonylurea were randomized to sitagliptin 100 mg (n = 307) or dapagliflozin 5 mg titrated to 10 mg (n = 306) once daily for 24 weeks. A longitudinal data analysis model was used to test the primary hypothesis that sitagliptin is non‐inferior to dapagliflozin in reducing HbA1c at Week 24, with superiority to be tested if non‐inferiority is met. https://ClinicalTrials.gov NCT02532855.ResultsBaseline mean HbA1c (% [mmol/mol]) was 7.7 (60.9) and 7.8 (61.2), and mean eGFR (mL/min/1.73m2) was 79.4 and 76.9 for the sitagliptin and dapagliflozin groups, respectively. After 24 weeks, the between‐group difference in least squares mean (95% CI) changes from baseline in HbA1c was −0.15% (−0.26, −0.04) (−1.67 mmol/mol [−2.86, −0.48]), P = 0.006, meeting the prespecified criteria for declaring both non‐inferiority and superiority of sitagliptin versus dapagliflozin. The HbA1c goal of <7% (<53 mmol/mol) was met by 43% (sitagliptin) and 27% (dapagliflozin) of patients. No meaningful between‐group difference was observed in a pre‐specified analysis of 2‐hour incremental postprandial glucose excursion. A review of adverse events (AEs) was notable for a lower incidence of drug‐related AEs with sitagliptin compared with dapagliflozin.ConclusionsIn patients with type 2 diabetes, mild renal insufficiency and inadequate glycaemic control on metformin ± sulfonylurea, sitagliptin treatment resulted in greater improvement in glycaemic control compared with dapagliflozin and was generally well tolerated.

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“…Progression rate of retinopathy in older persons has been shown to be directly related to their HbA 1 C level [16]. Persons with diabetes are more likely to develop infection, including recurrence of tuberculosis [17].…”

Section: Reasons For Maintenance Of Euglycemia In Older Diabeticsmentioning

confidence: 99%

Diabetes mellitus in older men

et al. 2006

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Most persons with diabetes mellitus are over the age of 60 years. Males develop diabetes more commonly than females. Older diabetics tend to have both impaired insulin release as well as insulin resistance. In older persons diabetes mellitus is associated with decreased functional status and cognitive dysfunction. In general, older persons with diabetes are inclined to be underdiagnosed and undertreated. Managing diabetes in older persons requires special considerations because of their differences in pathophysiology of diabetes and strong association with functional, cognitive impairments and comorbidities. The use of strict therapeutic diets is not recommended in older persons. Treatment of hypertension and hyperglycemia can improve outcomes in older persons. The interdisciplinary team approach is important for care of older diabetic persons.

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Retinopathy in Older Type II Diabetics Association With Glucose Control

Cited by 107 publications

References 0 publications

Hyperhomocysteinemia Is Associated With the Presence of Retinopathy in Type 2 Diabetes Mellitus

Hyperhomocysteinemia Is Associated With the Presence of Retinopathy in Type 2 Diabetes Mellitus

A randomized clinical trial of the efficacy and safety of sitagliptin compared with dapagliflozin in patients with type 2 diabetes mellitus and mild renal insufficiency: The CompoSIT‐R study

Diabetes mellitus in older men

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