Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Glycemic Treatment’s Effect When CV Risk Is High

Diabetes Care; ePub Dec 20; Basu, Raghavan, et al

Certain characteristics can help predict benefit and harm from intensive glycemic therapy, according to a study involving >10,250 individuals. Investigators used machine learning to understand the variation in all-cause mortality in intensively treated ACCORD trial participants with type 2 diabetes, HbA1c ≥7.5%, and cardiovascular disease (CVD) or multiple CVD risk factors. Among the results:

  • 4 groups defined by age, BMI, and HbA1c glycation index (HGI) were identified as having varied mortality risk when receiving intensive glycemic therapy.
  • Patients <61 years of age with an HGI <0.44 and BMI <30 kg/m2 had a 2.3% decreased risk of mortality attributable to intensive therapy (number needed to treat: 43).
  • Those with higher HGI had a 3.7% increased risk attributable to intensive therapy (number needed to harm: 27).

Citation:

Basu S, Raghavan S, Wexler D, Berkowitz S. Characteristics associated with decreased or increased mortality risk from glycemic therapy among patients with type 2 diabetes and high cardiovascular risk: Machine learning analysis of the ACCORD trial. [Published online ahead of print December 20, 2017]. Diabetes Care. doi:10.2337/dc17-2252.

This Week's Must Reads

LB Women Develop T2D Younger Than Hetero Women, Diabetes Care; ePub 2018 May 2; Corliss, et al

BMI Trajectories from Birth to Young Adulthood, Obesity; ePub 2018 Apr 19; McGinty, et al

Meat Cooking Methods and Type 2 Diabetes Risk, Diabetes Care; 2018 May; Liu, Zong, et al

Gestational Diabetes and Renal Function Examined, Diabetes Care; ePub 2018 May 4; Rawal, et al

Daily Steps Activity Linked with Weight Loss, Obesity; ePub 2018 Apr 6; Creasy, Lang, et al

Must Reads in Obesity

BMI Trajectories from Birth to Young Adulthood, Obesity; ePub 2018 Apr 19; McGinty, et al

Daily Steps Activity Linked with Weight Loss, Obesity; ePub 2018 Apr 6; Creasy, Lang, et al

Poor Sleep Quality Linked with Insulin Resistance, Metab Syndr Relat Disord; ePub 2018 Mar 20; Kline, et al

Chronic Stress, Risk Taking, and Visceral Fat, Obesity; ePub 2018 Mar 22; Mason, et al

Obesity Progression and Incident Diabetes Examined, Diabetes Care; ePub 2018 Mar 5; Stokes, Collins, et al