Diabetes Research and Clinical Practice, Journal Year: 2024, Volume and Issue: unknown, P. 111965 - 111965
Published: Dec. 1, 2024
Language: Английский
Expert Opinion on Drug Safety, Journal Year: 2024, Volume and Issue: 23(7), P. 797 - 810
Published: May 13, 2024
Patients with type 2 diabetes (T2DM) are at high risk of atherosclerotic cardiovascular disease (ASCVD) and death. Cardiovascular protection is a key objective in T2DM.
Language: Английский
Citations
4
Cureus, Journal Year: 2025, Volume and Issue: unknown
Published: Jan. 8, 2025
The underutilization of sodium-glucose co-transporter type 2 inhibitors (SGLT2i), despite their proven cardiovascular and renal benefits, raises concerns about healthcare equity. SGLT2i effectively reduces proteinuria, a key indicator kidney disease, making them an essential treatment for individuals with or without diabetes, particularly those at higher risk, such as the Black American population, who have prevalence proteinuria. However, studies show disparities in prescriptions race, ethnicity, socioeconomic status contributing to lower utilization rates among vulnerable populations. This study aims explore prescription patterns Maryland, focusing on patients proteinuria address these improve access care. objective was identify racial SGLT2i. retrospective cohort utilized de-identified electronic health records (EHR) sourced from Epic database across University Maryland Medical System (UMMS), spanning 10-year period January 1, 2014, December 31, 2023, evaluated Of 5,866,616 UMMS system, 28,136 were diagnosed whom 4,360 (15.5%) prescribed medications. Among receiving prescriptions, 37.9% self-identified American, while 54.7% identified White American. Notable geographical observed rates. In affluent areas Fulton, MD (zip code 20759), only 0.046% received compared 1.4% lower-income area West Baltimore, 21223). Bivariate analysis revealed significant rates, having odds (OR = 0.68, p < 0.001) like Fulton showing significantly Baltimore 0.31, 0.001). These persisted multivariate analysis, where had adjusted PR (AOR) 0.72 (p 0.002) relative patients, residents (AOR 1.72, 0.01) reduced 0.35, 0.02). reveals United States, highlighting influence factors vital treatments. Despite established benefits managing reducing risk systemic inequities persist, potentially leaving high-risk populations underserved. findings call deeper examination structural barriers disparities, well development strategies promote equitable Ensuring that all regardless background status, evidence-based therapies is improving outcomes inequities.
Language: Английский
Citations
0
International Journal of Cardiology, Journal Year: 2025, Volume and Issue: unknown, P. 133079 - 133079
Published: Feb. 1, 2025
Language: Английский
Citations
0
Diabetes Obesity and Metabolism, Journal Year: 2025, Volume and Issue: unknown
Published: March 14, 2025
Abstract Aim Diabetic kidney disease (DKD) is a major complication of diabetes, including in insulin‐deficient phenotypes, yet data on outcomes with sodium‐glucose cotransporter 2 inhibitors (SGLT2i) this population are limited. This study investigates the impact SGLT2i patients diabetes using real world data. Materials and Methods retrospective cohort utilized from large Health Maintenance Organization Israel included 12,530 propensity score‐matched adults diabetes. Patients were categorized into users non‐users followed for median 1657 days. The primary outcome was composite ≥50% decline eGFR to <60 mL/min/1.73 m or progression <15 . Secondary doubling serum creatinine changes albuminuria category. Results use associated reduced incidence (6.1% vs. 7.5%; HR 0.79, p < 0.001). analyses revealed significant reductions (HR 0.76, 0.001) improvements albuminuria, 51% transitioning normoalbuminuria. Benefits consistent across subgroups. Although diabetic ketoacidosis (DKA) higher among (2.81% 2.19%, = 0.03), overall frequency low. Conclusions demonstrated substantial protection patients, extending benefits beyond type These findings highlight as potential therapeutic option mitigating DKD high‐risk populations.
Language: Английский
Citations
0
American Journal of Preventive Cardiology, Journal Year: 2025, Volume and Issue: unknown, P. 100966 - 100966
Published: April 1, 2025
Language: Английский
Citations
0
Clinical Transplantation, Journal Year: 2024, Volume and Issue: 38(4)
Published: April 1, 2024
Abstract Background Recent clinical trials demonstrate benefits of sodium‐glucose cotransporter‐2 inhibitors (SGLT2i) in patients with chronic kidney disease, but data on use transplant (KTx) recipients are limited. Methods We examined a novel database linking SRTR registry for KTx (2000–2021) outpatient fill records from large pharmaceutical claims warehouse (2015–2021). Adult (≥18 years) treated SGLT2i were compared to those who received other noninsulin diabetes medications without SGLT2i. Characteristics associated quantified by multivariable logistic regression (adjusted odds ratio, 95%LCL aOR 95%UCL ). Results Among 18 988 agents the study period, 2224 filled an Mean time prescription was 6.7 years versus 4.7 non‐SGLT2i medications. more common Asian adults (aOR, 1.09 1.31 1.58 ) and aged > 30–59 (compared 18–30 or BMI 35 kg/m 2 1.19 1.41 1.67 ), trended higher self‐pay status. lower among women .79 .87 .96 Black .77 .88 1.00 .52 .75 1.07 race, publicly insured .82 .92 1.03 less than college education .78 age 75 older. increased dramatically 2019–2021 5.01 5.63 6.33 vs. prior years). Conclusion is increasing varies factors including education, insurance. While ongoing needed define risks patients, attention should also focus reducing treatment disparities related sociodemographic traits.
Language: Английский
Citations
3
Medicine, Journal Year: 2025, Volume and Issue: 104(18), P. e42196 - e42196
Published: May 2, 2025
Background: To investigate the efficacy and safety of sodium-glucose cotransporter 2 (SGLT-2) inhibitors in patients with heart failure (HF) type diabetes mellitus (T2DM). Methods: A manual search was conducted 3 prestigious English databases, Cochrane Library, PubMed, Web Science, for studies published within last decade, from July 2014 to 2024. The extracted literature synthesized analyze outcomes, survival prognostic indicators, profiles SGLT-2 HF T2DM. bias risk assessment scale used as a tool evaluate quality literature, Review Manager 5.4 software create chart. Data analysis merging were completed help Stata 15.0 statistical software. Results: Twelve encompassing 9509 included meta-analysis. results revealed that compared control group, inhibitor-treated group demonstrated significantly greater reductions left ventricular end-diastolic volume index [mean difference (MD) = -7.25, 95% confidence intervals [95% CI] (-9.83, -4.67)], brain natriuretic peptide levels [MD -36.96, CI (-63.51, -10.41)], N-terminal pro-brain -519.27, (-660.77, -377.78)]. Furthermore, exhibited higher increases Kansas City Cardiomyopathy Questionnaire scores 3.32, (3.30, 3.34)], indicating improved life. Additionally, incidence adverse events lower [OR 0.78, (0.69, 0.88)]. pooled meta-analysis indicated inhibitor therapy reduced cardiovascular death or hospitalization by 23%, 19%, all-cause mortality 9%. Conclusion: risks mortality, death, improve cardiac function, decrease events, enhance life these patients.
Language: Английский
Citations
0
Journal of Clinical and Translational Science, Journal Year: 2024, Volume and Issue: 8(1)
Published: Jan. 1, 2024
Type 2 diabetes (T2DM) poses a significant public health challenge, with pronounced disparities in control and outcomes. Social determinants of (SDoH) significantly contribute to these disparities, affecting healthcare access, neighborhood environments, social context. We discuss the design, development, use an innovative web-based application integrating real-world data (electronic record geospatial files), enhance comprehension impact SDoH on T2 DM disparities.
Language: Английский
Citations
2
Diabetes Obesity and Metabolism, Journal Year: 2024, Volume and Issue: 27(2), P. 835 - 844
Published: Nov. 27, 2024
Over recent years, therapy options and strategies for type 2 diabetes mellitus (T2DM) have developed substantially. This study investigated glucose-lowering treatment in patients with high cardiovascular risk over three decades.
Language: Английский
Citations
2
medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2023, Volume and Issue: unknown
Published: Aug. 25, 2023
Abstract Aims Limited recent data exist on prescribing patterns and patient characteristics for glucagon-like peptide 1 receptor agonists (GLP-1 RAs), an important drug class patients with type 2 diabetes mellitus (T2D) and/or overweight or obesity. We describe trends in first-time of GLP-1 RAs. Materials Methods Using aggregated US electronic health record data, we identified prescriptions RAs between January 2018 June 2023 adults receiving regular care. volumes stratified by characteristics, specific drug, FDA-labelled indication. The 5.5-year analysis period was divided into six-month periods. Results In total, 274,562 were newly prescribed a RA, significant increase over time (January to June, 2018: 9,642 versus 2023: 66,569; p < 0.001). Overall, 181,860 (66.2%) had T2D 229,715 (83.7%) obesity overweight. proportion decreased through 84.1% 49%; 0.001), while the increased 75.9% 90.7%; <.001). Of known indication (74.2%), 87% labelled 13% Patients first RA 59.1% female mean (SD) age 58.6 (13) years, those 82.9% female, 48.2 (12.2) years. Conclusions observed overall, shift away from predominately population.
Language: Английский
Citations
3