Intensive Glycemic Therapy in Patients With Type 2 Diabetes on ß-Blockers  

Oleh:

Tsujimoto, Tetsuro ; Sugiyama, Takehiro ; Noda, Mitsuhiko ; Kajio, Hiroshi

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Diabetes Care vol. 39 no. 10 (Oct. 2016), page 1818-1826.
Topik: Type 2 Diabetes; T2D

Ketersediaan

Perpustakaan FK Nomor Panggil: D05.K Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

OBJECTIVE Recent studies have suggested that ß-blockers may decrease the adverse influence of hypoglycemia and reduce hypoglycemia-associated cardiac arrhythmias and death. We evaluated whether intensive glycemic therapy in patients with diabetes receiving treatment with ß-blockers showed beneficial effects for the prevention of cardiovascular events without increased mortality compared with a standard glycemic therapy. RESEARCH DESIGN AND METHODS We used Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial data to assess the risks of cardiovascular events, all-cause death, and cardiovascular death in patients with diabetes receiving treatment with ß-blockers (n = 3,079) and not receiving treatment with ß-blockers (n = 7,145) using Cox proportional hazard models. RESULTS In patients receiving treatment with ß-blockers, the cumulative event rates for cardiovascular events were significantly lower in the intensive therapy group compared with the standard therapy group (hazard ratio [HR] 0.81; 95% CI 0.67–0.97; P = 0.02), whereas those rates in patients not receiving treatment with ß-blockers were not significantly different (HR 0.92; 95% CI 0.78–1.09; P = 0.36). Conversely, the cumulative event rates for all-cause and cardiovascular deaths in patients receiving treatment with ß-blockers were not significantly different between the standard therapy and intensive therapy groups (all-cause death: HR 1.08; 95% CI 0.83–1.42; P = 0.54; cardiovascular death: HR 1.05; 95% CI 0.72–1.51; P = 0.79), whereas in patients not receiving treatment with ß-blockers, the event rates were significantly higher in the intensive therapy group compared with the standard therapy group (all-cause death: HR 1.25; 95% CI 1.02–1.52; P = 0.02; cardiovascular death: HR 1.43; 95% CI 1.03–1.98; P = 0.03). CONCLUSIONS Intensive glycemic therapy may be effective in patients with type 2 diabetes receiving treatment with ß-blockers.

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