The most important predictors of the trajectory of glucose control were body mass index and levels of HbA1c and triglycerides, according to the study of registry data from the Netherlands.
The retrospective study involved nearly 2.8 million male veterans 65 to 99 years of age, 32.3% with diabetes, who received primary care at Veterans Health Administration medical centers from 2000 to 2010.
The results provide further evidence that insulin pump therapy is safe and effective, even in routine diabetes care for unselected patients, according to the study authors.
Cardiovascular event rates similar between once-weekly exenatide and placebo in patients with type 2 diabetes
A limitation of the industry-funded randomized trial was the high rate of early discontinuation: 43.0% of patients on exenatide and 45.2% of those on placebo.
From 2000 to 2014, the age-standardized incidence of end-stage renal disease (ESRD) attributed to diabetes decreased from 260.2 to 173.9 per 100,000 diabetic population.
Risk of atrial fibrillation increased with worse glycemic control and renal complications. Among patients with normoalbuminuria, researchers found no excess risk of atrial fibrillation with an HbA1c less than 9.7% for men or 8.8% for women.
Although it would seem to make sense that routine glucose self-monitoring provides better outcomes, this long-held belief is not supported by the data, said an editor's note accompanying the study.
The review included 189 randomized controlled trials that compared glucagon-like peptide-1 receptor agonists or dipeptidyl peptidase-2 inhibitors with placebo or other diabetes drugs in patients with type 2 diabetes.
The hypoglycemia risk stratification tool is based on six variables: previous episodes of hypoglycemia-related hospital utilization, insulin use, sulfonylurea use, ED use in the previous year, chronic kidney disease stage, and age.
Results from the Diabetes Prevention Program Outcomes Study also showed that metformin was cost-effective compared to placebo for patients at high risk of diabetes.