Impact of Excessive Weight Gain on Cardiovascular Outcomes in Type 1 Diabetes: Results From the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study
| العنوان: | Impact of Excessive Weight Gain on Cardiovascular Outcomes in Type 1 Diabetes: Results From the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study |
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| المؤلفون: | G. Ziegler, Patricia A. Cleary, Rose Gubitosi-Klug, William I. Sivitz, Barbara H. Braffett, Bernard Zinman, Jonathan Q. Purnell, John P. Bantle, John D. Brunzell |
| المصدر: | Diabetes Care |
| بيانات النشر: | American Diabetes Association, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Adult, Male, Cardiovascular and Metabolic Risk, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, 030204 cardiovascular system & hematology, Weight Gain, Body Mass Index, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Risk Factors, law, Internal medicine, Diabetes mellitus, Internal Medicine, medicine, Humans, Hypoglycemic Agents, Insulin, Proportional Hazards Models, Advanced and Specialized Nursing, Type 1 diabetes, business.industry, Proportional hazards model, Incidence, Incidence (epidemiology), medicine.disease, Diabetes Mellitus, Type 1, Treatment Outcome, Cardiovascular Diseases, Female, Observational study, medicine.symptom, business, Body mass index, Weight gain, Follow-Up Studies |
| الوصف: | OBJECTIVE Intensive treatment (INT) of type 1 diabetes reduces the incidence of cardiovascular disease (CVD) events compared with conventional treatment (CONV), but it also results in more weight gain. Our objective was to examine whether excessive weight gain from INT of type 1 diabetes is independently associated with subsequent CVD events. RESEARCH DESIGN AND METHODS Quartiles (Q) of weight gain in 1,213 participants aged 18 years and older at enrollment in the Diabetes Control and Complications Trial (DCCT) were determined within randomized treatment groups (INT vs. CONV) using change in BMI from baseline to the closeout DCCT visits. Effects of this weight gain on CVD risk factors and outcomes during an additional 20 years of observational follow-up were then determined. RESULTS The Q4 INT group experienced greater proportional weight gain (median change in BMI, 6.08 kg/m2), increases in CVD risk factors, and need for medications for hypertension and lipids compared with the Q1–3 INT and comparable CONV groups. Over a mean of 26 years of follow-up, the numbers of major and total CVD events were not statistically different in Q4 compared with Q1–3 of either the INT or CONV group. By year 14, however, the incident CVD event curve became significantly higher in the Q4 INT group than in the Q1–3 INT groups (P = 0.024) and was similar to that for the CONV group. CONCLUSIONS For the first 13 years after DCCT, INT for type 1 diabetes reduced macrovascular events compared with CONV, even when excessive weight gain occurred. After this, total CVD events significantly increased in the Q4 INT group, becoming equivalent to those in the CONV group. Longer follow-up is needed to determine whether this trend continues and results in more major CVD events. |
| تدمد: | 1935-5548 0149-5992 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3a1079a9145e24d77dca86e66559b5beTest https://doi.org/10.2337/dc16-2523Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....3a1079a9145e24d77dca86e66559b5be |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19355548 01495992 |
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