Study finds potential early indicators of myocardial dysfunction in asymptomatic elderly patients with type 2 diabetes
Researchers examined asymptomatic patients 65 years of age and older with type 2 diabetes and preserved left ventricular ejection fraction to look for impaired global longitudinal strain, diastolic dysfunction, or left atrial enlargement.
Patients with diabetes who were taking any beta-blocker, a beta-1 selective beta-blocker, or a specific beta-blocker had significantly higher risk for all-cause mortality versus patients with diabetes who were not taking a beta-blocker.
Between 2007 and 2014, more Medicare beneficiaries were newly prescribed metformin, dipeptidyl peptidase-4 inhibitors, and sodium-glucose cotransporter 2 inhibitors, while fewer received long-acting sulfonylureas or thiazolidinediones.
The retrospective study at a single tertiary care referral medical center compared cost-effectiveness of care from a specialized diabetes team with care from a primary service team.
After four years of follow-up, patients who had received intensive treatment during the trial had similar systolic blood pressure (BP) to those who had been on standard treatment but lower rates of cardiovascular (CV) events.
Patients with type 2 diabetes who had Roux-en-Y gastric bypass surgery maintained significant, although shrinking, improvements in HbA1c compared to those receiving lifestyle and medical management.
The researchers found an inverse association between insulin initiation and age, and black and Hispanic participants were less likely to have insulin initiated compared with white participants.
Review: Evidence is inconclusive on metabolic surgery vs. medical treatment for microvascular complications in T2DM
They also highlight the need for further RCTs assessing the effect of metabolic surgery on microvascular diabetes outcomes.
A cost-effectiveness analysis found that individualized control saved $13,547 per patient compared with uniform intensive control, primarily due to lower medication costs, and increased quality-adjusted life-years by 0.10.
Cardiovascular benefits of adding ezetimibe to statin therapy may be greater in patients with diabetes, study finds
Participants were randomized to receive either ezetimibe or placebo in addition to background simvastatin, and the subgroup of patients with diabetes was compared to those without the disease.