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Complications of Type 2 Diabetes

Complications of Type 2 Diabetes

  • Complications of Type 2 Diabetes
  • Hypothyroidism Is a Risk Factor for DM Patients. • Hypothyroidism is a risk factor for new onset DM, according to a large cohort study. • The researchers matched up 39,263 statin nonusers with 20,334 highly compliant statin initiators in 2004–2005 and followed them until the end of 2010. • In a multivariable model, hypothyroidism and subclinical hypothyroidism carried an increased risk for DM.
  • Statin Users Have a Higher Risk. • The risk of DM with hypothyroidism was higher among statin users (relative risk (RR) 2.06) than for statin nonusers (RR 1.66). • Subclinical hypothyroidism risk for DM was prominent only in statin users (RR 1.94) and not nonusers (RR 1.20). • Patients with hypothyroidism treated with thyroid hormone replacement therapy were not at increased risk for DM. • The researchers suggest that identifying and treating hypothyroidism and subclinical hypothyroidism might reduce the risk of DM.
  • Hypoglycemia Associated with Depression in Type 2 DM. • Severe hypoglycemia is associated with depressive symptoms in Japanese patients with type 2 DM, according to a new cross-sectional study. • These researchers investigated the relationship of the severity of depressive symptoms with clinical parameters, including an episode of severe hypoglycemia, in 4,218 Japanese patients with type 2 DM. • After multivariate adjustments, the severity of depressive symptoms was significantly associated with body mass index, leisure-time physical activity, current smoking, sleep duration, sucrose intake, skipping breakfast, insulin use, severe hypoglycemia, dysesthesia of both feet, history of foot ulcer, photocoagulation, ischemic heart disease, and stroke.
  • Severe Hypoglycemia Increases with Severe Depression. • For 2,756 sulfonylurea and/or insulin-treated patients, the risk for severe hypoglycemia increased significantly with their depression score. • The association of severe hypoglycemia with depression may have great impact on the prognosis in patients with type 2 DM. • Since severe hypoglycemia and depression are known risk factors for morbidity and mortality in patients with diabetes, clinicians should be aware of this combination.
  • HbA1c Associated with Risks of MI. • HbA1c variables are associated with MI risk, according to a large cohort study. • These researchers examined the risk of MI by impaired glycemic control in a cohort of 101,799 patients with type 2 DM who were diagnosed between 1995 and 2001. • The patients were divided into an early cohort (diagnosed from 1997 and 2004) and a recent cohort (diagnosed from 2004 to 2011). • The correlation between three HbA1c metrics and MI was examined.
  • Increased Risks for HbA1c less than 6%. • The risk increase for MI per 1% increase in HbA1c was higher for updated latest and updated mean HbA1c than for baseline HbA1c in the overall cohort. • The corresponding risk estimates were greater in the early versus the recent cohort. • In the recent cohort, but not the early cohort, the updated latest variable showed an increased risk for HbA1c less than 6%. • The 2 time-updated HbA1c variables show stronger associations with risk of MI than baseline HbA1c, and the association between HbA1c and risk of MI has decreased over time.
  • Take-home Messages. • Hypothyroidism is a risk factor for DM, with a subclinical hypothyroidism-associated risk for DM prominent only in statin users. • The combination of severe hypoglycemia and depression are known risk factors for morbidity and mortality in patients with type 2 DM. • In recently diagnosed patients with type 2 DM, an increased risk of MI exists at a current HbA1c of less than 6%.

Hypothyroidism is a risk factor for new onset diabetes mellitus (DM), in particular for those who take statins. Severe hypoglycemia is significantly associated with the severity of depressive symptoms among type 2 DM patients. Time-updated hemoglobin A1c (HbA1c) variables have a stronger association with myocardial infarction (MI) than baseline HbA1c.

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