Impact of metabolic control on all-cause mortality in a nationwide cohort of patients with diabetes from Colombia
ObjectiveThe magnitude of the mortality benefit conferred by good integral metabolic control in diabetes in not sufficiently known, especially among Latin American patients. We prospectively studied the association between sustained control of blood glucose (HbA1c<7%), systolic blood pressure...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2023.1073833/full |
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| author | Carlos O. Mendivil Carlos O. Mendivil Mateo Amaya-Montoya Juliana Alexandra Hernández-Vargas Nathaly Ramírez-García Lina Johana Herrera-Parra Valentina Guatibonza-García Camila Romero-Díaz Agustín Pérez-Londoño Lizbeth Acuña-Merchán |
| author_facet | Carlos O. Mendivil Carlos O. Mendivil Mateo Amaya-Montoya Juliana Alexandra Hernández-Vargas Nathaly Ramírez-García Lina Johana Herrera-Parra Valentina Guatibonza-García Camila Romero-Díaz Agustín Pérez-Londoño Lizbeth Acuña-Merchán |
| author_sort | Carlos O. Mendivil |
| collection | DOAJ |
| description | ObjectiveThe magnitude of the mortality benefit conferred by good integral metabolic control in diabetes in not sufficiently known, especially among Latin American patients. We prospectively studied the association between sustained control of blood glucose (HbA1c<7%), systolic blood pressure (SBP) (<130 mmHg) and LDL (LDLc, <100mg/dL) and non-HDL (non-HDLc, <130 mg/dL) cholesterol, and death from any cause among all adult patients with diagnosed diabetes in Colombia.MethodsWe retrospectively analyzed data from a nationwide, centralized, mandatory registry of all patients with diagnosed diabetes assisted by the Colombian health system between July 1, 2015, and June 30, 2019. We estimated the associations of sustained achievement of each goal, and of the joint triple goal (HbA1c + SBP + LDLc) with all-cause death. Associations were assessed after adjustment for sex, age, race, insurance type and BMI in multivariable logistic models.ResultsWe studied 1 352 846 people with diabetes. Sustained SBP (OR 0.42 [0.41-0.43]), HbA1c (OR 0.25 [0.24-0.26]) and LDLc (OR 0.28 [0.27-0.29]) control had strong negative associations with death. Moreover, among the 5.4% of participants who achieved joint, sustained metabolic control, the OR for death was 0.19 (0.18-0.21). Importantly, the impact of sustained, joint metabolic control was significantly smaller for patients of black race compared to other races (OR 0.31 [0.23-0.43] versus 0.18 [0.17-0.20], p-value for interaction <0.001), mostly at the expense of a smaller impact of LDLc control. The results were similar across body-mass index categories.ConclusionsSustained and simultaneous metabolic control was associated with remarkably lower odds of death. |
| first_indexed | 2024-04-10T21:40:18Z |
| format | Article |
| id | doaj.art-6200257f622a48e78bebc5208bb9e7c7 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-10T21:40:18Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-6200257f622a48e78bebc5208bb9e7c72023-01-19T05:48:47ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922023-01-011410.3389/fendo.2023.10738331073833Impact of metabolic control on all-cause mortality in a nationwide cohort of patients with diabetes from ColombiaCarlos O. Mendivil0Carlos O. Mendivil1Mateo Amaya-Montoya2Juliana Alexandra Hernández-Vargas3Nathaly Ramírez-García4Lina Johana Herrera-Parra5Valentina Guatibonza-García6Camila Romero-Díaz7Agustín Pérez-Londoño8Lizbeth Acuña-Merchán9School of Medicine, Universidad de los Andes, Bogotá, ColombiaEndocrinology Section, Department of Internal Medicine, Fundación Santa Fe de Bogotá, Bogotá, ColombiaSchool of Medicine, Universidad de los Andes, Bogotá, ColombiaCuenta de Alto Costo, Fondo Colombiano de Enfermedades de Alto Costo, Bogotá, ColombiaCuenta de Alto Costo, Fondo Colombiano de Enfermedades de Alto Costo, Bogotá, ColombiaCuenta de Alto Costo, Fondo Colombiano de Enfermedades de Alto Costo, Bogotá, ColombiaSchool of Medicine, Universidad de los Andes, Bogotá, ColombiaSchool of Medicine, Universidad de los Andes, Bogotá, ColombiaSchool of Medicine, Universidad de los Andes, Bogotá, ColombiaCuenta de Alto Costo, Fondo Colombiano de Enfermedades de Alto Costo, Bogotá, ColombiaObjectiveThe magnitude of the mortality benefit conferred by good integral metabolic control in diabetes in not sufficiently known, especially among Latin American patients. We prospectively studied the association between sustained control of blood glucose (HbA1c<7%), systolic blood pressure (SBP) (<130 mmHg) and LDL (LDLc, <100mg/dL) and non-HDL (non-HDLc, <130 mg/dL) cholesterol, and death from any cause among all adult patients with diagnosed diabetes in Colombia.MethodsWe retrospectively analyzed data from a nationwide, centralized, mandatory registry of all patients with diagnosed diabetes assisted by the Colombian health system between July 1, 2015, and June 30, 2019. We estimated the associations of sustained achievement of each goal, and of the joint triple goal (HbA1c + SBP + LDLc) with all-cause death. Associations were assessed after adjustment for sex, age, race, insurance type and BMI in multivariable logistic models.ResultsWe studied 1 352 846 people with diabetes. Sustained SBP (OR 0.42 [0.41-0.43]), HbA1c (OR 0.25 [0.24-0.26]) and LDLc (OR 0.28 [0.27-0.29]) control had strong negative associations with death. Moreover, among the 5.4% of participants who achieved joint, sustained metabolic control, the OR for death was 0.19 (0.18-0.21). Importantly, the impact of sustained, joint metabolic control was significantly smaller for patients of black race compared to other races (OR 0.31 [0.23-0.43] versus 0.18 [0.17-0.20], p-value for interaction <0.001), mostly at the expense of a smaller impact of LDLc control. The results were similar across body-mass index categories.ConclusionsSustained and simultaneous metabolic control was associated with remarkably lower odds of death.https://www.frontiersin.org/articles/10.3389/fendo.2023.1073833/fulldiabetesmetabolic controlcomplicationsmortalityLatin America |
| spellingShingle | Carlos O. Mendivil Carlos O. Mendivil Mateo Amaya-Montoya Juliana Alexandra Hernández-Vargas Nathaly Ramírez-García Lina Johana Herrera-Parra Valentina Guatibonza-García Camila Romero-Díaz Agustín Pérez-Londoño Lizbeth Acuña-Merchán Impact of metabolic control on all-cause mortality in a nationwide cohort of patients with diabetes from Colombia Frontiers in Endocrinology diabetes metabolic control complications mortality Latin America |
| title | Impact of metabolic control on all-cause mortality in a nationwide cohort of patients with diabetes from Colombia |
| title_full | Impact of metabolic control on all-cause mortality in a nationwide cohort of patients with diabetes from Colombia |
| title_fullStr | Impact of metabolic control on all-cause mortality in a nationwide cohort of patients with diabetes from Colombia |
| title_full_unstemmed | Impact of metabolic control on all-cause mortality in a nationwide cohort of patients with diabetes from Colombia |
| title_short | Impact of metabolic control on all-cause mortality in a nationwide cohort of patients with diabetes from Colombia |
| title_sort | impact of metabolic control on all cause mortality in a nationwide cohort of patients with diabetes from colombia |
| topic | diabetes metabolic control complications mortality Latin America |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2023.1073833/full |
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