Serveur d'exploration sur les relations entre la France et l'Australie

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Estimation of individual beneficial and adverse effects of intensive glucose control for patients with type 2 diabetes.

Identifieur interne : 003A81 ( Ncbi/Merge ); précédent : 003A80; suivant : 003A82

Estimation of individual beneficial and adverse effects of intensive glucose control for patients with type 2 diabetes.

Auteurs : Joep Van Der Leeuw [Pays-Bas] ; Frank L J. Visseren [Pays-Bas] ; Mark Woodward [Australie] ; Yolanda Van Der Graaf [Pays-Bas] ; Diederick E. Grobbee [Pays-Bas] ; Stephen Harrap [Australie] ; Simon Heller [Royaume-Uni] ; Giuseppe Mancia [Italie] ; Michel Marre [France] ; Neil Poulter [Royaume-Uni] ; Sophia Zoungas [Australie] ; John Chalmers [Australie]

Source :

RBID : pubmed:27586250

Descripteurs français

English descriptors

Abstract

Intensive glucose control reduces the risk of vascular complications while increasing the risk of severe hypoglycaemia at a group level. We sought to estimate individual beneficial and adverse effects of intensive glucose control in patients with type 2 diabetes.

DOI: 10.1007/s00125-016-4082-5
PubMed: 27586250

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pubmed:27586250

Le document en format XML

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<div type="abstract" xml:lang="en">Intensive glucose control reduces the risk of vascular complications while increasing the risk of severe hypoglycaemia at a group level. We sought to estimate individual beneficial and adverse effects of intensive glucose control in patients with type 2 diabetes.</div>
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<Day>16</Day>
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<Article PubModel="Print-Electronic">
<Journal>
<ISSN IssnType="Electronic">1432-0428</ISSN>
<JournalIssue CitedMedium="Internet">
<Volume>59</Volume>
<Issue>12</Issue>
<PubDate>
<Year>2016</Year>
<Month>Dec</Month>
</PubDate>
</JournalIssue>
<Title>Diabetologia</Title>
<ISOAbbreviation>Diabetologia</ISOAbbreviation>
</Journal>
<ArticleTitle>Estimation of individual beneficial and adverse effects of intensive glucose control for patients with type 2 diabetes.</ArticleTitle>
<Pagination>
<MedlinePgn>2603-2612</MedlinePgn>
</Pagination>
<Abstract>
<AbstractText Label="AIMS/HYPOTHESIS" NlmCategory="OBJECTIVE">Intensive glucose control reduces the risk of vascular complications while increasing the risk of severe hypoglycaemia at a group level. We sought to estimate individual beneficial and adverse effects of intensive glucose control in patients with type 2 diabetes.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">We performed a post hoc analysis of the Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial, a randomised controlled trial evaluating standard vs intensive glucose control (HbA1c target ≤6.5% [48 mmol/mol]). In 11,140 participants, we estimated the individual 5 year absolute risk reduction (ARR) for the composite outcome of major micro- and macrovascular events and absolute risk increase (ARI) for severe hypoglycaemia for intensive vs standard glucose control. Predictions were based on competing risks models including clinical characteristics and randomised treatment.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Based on these models, 76% of patients had a substantial estimated 5 year ARR for major vascular events (>1%, 5 year number-needed-to-benefit [NNTB5] <100) and 1% had a small ARR (<0.5%, NNTB5 >200). Similarly, 36% of patients had a substantial estimated ARI for severe hypoglycaemia (5 year number-needed-to-harm [NNTH5] <100) and 29% had a small ARI (NNTH5 >200). When assigning similar or half the weight to severe hypoglycaemia compared with a major vascular event, net benefit was positive in 85% or 99% of patients, respectively. Limiting intensive treatment to the 85% patient subgroup had no significant effect on the overall incidence of major vascular events and severe hypoglycaemia compared with treating all patients.</AbstractText>
<AbstractText Label="CONCLUSIONS/INTERPRETATION" NlmCategory="CONCLUSIONS">Taking account of the effects of intensive glucose control on major micro- and macrovascular events and severe hypoglycaemia for individual patients, the estimated net benefit was positive in the majority of the participants in the ADVANCE trial. The estimated individual effects can inform treatment decisions once individual weights assigned to positive and adverse effects have been specified.</AbstractText>
<AbstractText Label="TRIAL REGISTRATION" NlmCategory="BACKGROUND">ClinicalTrials.gov NCT00145925.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y">
<Author ValidYN="Y">
<LastName>van der Leeuw</LastName>
<ForeName>Joep</ForeName>
<Initials>J</Initials>
<AffiliationInfo>
<Affiliation>Department of Vascular Medicine, University Medical Centre Utrecht, PO Box 85500, 3508 GA, Utrecht, the Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Visseren</LastName>
<ForeName>Frank L J</ForeName>
<Initials>FL</Initials>
<AffiliationInfo>
<Affiliation>Department of Vascular Medicine, University Medical Centre Utrecht, PO Box 85500, 3508 GA, Utrecht, the Netherlands. f.l.j.visseren@umcutrecht.nl.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Woodward</LastName>
<ForeName>Mark</ForeName>
<Initials>M</Initials>
<AffiliationInfo>
<Affiliation>The George Institute for Global Health, University of Sydney, Sydney, NSW, Australia.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>The George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, Oxford, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>van der Graaf</LastName>
<ForeName>Yolanda</ForeName>
<Initials>Y</Initials>
<AffiliationInfo>
<Affiliation>Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
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<LastName>Grobbee</LastName>
<ForeName>Diederick E</ForeName>
<Initials>DE</Initials>
<AffiliationInfo>
<Affiliation>Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
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<LastName>Harrap</LastName>
<ForeName>Stephen</ForeName>
<Initials>S</Initials>
<AffiliationInfo>
<Affiliation>The Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Heller</LastName>
<ForeName>Simon</ForeName>
<Initials>S</Initials>
<AffiliationInfo>
<Affiliation>University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Mancia</LastName>
<ForeName>Giuseppe</ForeName>
<Initials>G</Initials>
<AffiliationInfo>
<Affiliation>Istituto Auxologico Italiano, University of Milano-Bicocca, Milan, Italy.</Affiliation>
</AffiliationInfo>
</Author>
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<LastName>Marre</LastName>
<ForeName>Michel</ForeName>
<Initials>M</Initials>
<AffiliationInfo>
<Affiliation>Hôpital Bichat-Claude Bernard and Université Paris 7, Paris, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Poulter</LastName>
<ForeName>Neil</ForeName>
<Initials>N</Initials>
<AffiliationInfo>
<Affiliation>International Centre for Circulatory Health, Imperial College, London, UK.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Zoungas</LastName>
<ForeName>Sophia</ForeName>
<Initials>S</Initials>
<AffiliationInfo>
<Affiliation>The George Institute for Global Health, University of Sydney, Sydney, NSW, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y">
<LastName>Chalmers</LastName>
<ForeName>John</ForeName>
<Initials>J</Initials>
<AffiliationInfo>
<Affiliation>The George Institute for Global Health, University of Sydney, Sydney, NSW, Australia.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
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<DataBankName>ClinicalTrials.gov</DataBankName>
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<AccessionNumber>NCT00145925</AccessionNumber>
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<ArticleDate DateType="Electronic">
<Year>2016</Year>
<Month>09</Month>
<Day>01</Day>
</ArticleDate>
</Article>
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<Country>Germany</Country>
<MedlineTA>Diabetologia</MedlineTA>
<NlmUniqueID>0006777</NlmUniqueID>
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<QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName>
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<MeshHeading>
<DescriptorName UI="D002318" MajorTopicYN="N">Cardiovascular Diseases</DescriptorName>
<QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D003924" MajorTopicYN="N">Diabetes Mellitus, Type 2</DescriptorName>
<QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D004338" MajorTopicYN="N">Drug Combinations</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
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<DescriptorName UI="D005907" MajorTopicYN="N">Gliclazide</DescriptorName>
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<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
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<DescriptorName UI="D006442" MajorTopicYN="N">Hemoglobin A, Glycosylated</DescriptorName>
<QualifierName UI="Q000378" MajorTopicYN="N">metabolism</QualifierName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D007003" MajorTopicYN="N">Hypoglycemia</DescriptorName>
<QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName>
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<MeshHeading>
<DescriptorName UI="D007004" MajorTopicYN="N">Hypoglycemic Agents</DescriptorName>
<QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
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<QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
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<MeshHeading>
<DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading>
<DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
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<DescriptorName UI="D020913" MajorTopicYN="N">Perindopril</DescriptorName>
<QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
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<MeshHeading>
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<QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName>
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<MeshHeading>
<DescriptorName UI="D040242" MajorTopicYN="N">Risk Reduction Behavior</DescriptorName>
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<Keyword MajorTopicYN="N">Glycaemic target</Keyword>
<Keyword MajorTopicYN="N">Hypoglycaemia</Keyword>
<Keyword MajorTopicYN="N">Net benefit</Keyword>
<Keyword MajorTopicYN="N">Personalised medicine</Keyword>
<Keyword MajorTopicYN="N">Type 2 diabetes</Keyword>
<Keyword MajorTopicYN="N">Vascular complications</Keyword>
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<Year>2016</Year>
<Month>03</Month>
<Day>04</Day>
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<Year>2016</Year>
<Month>07</Month>
<Day>27</Day>
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<li>France</li>
<li>Italie</li>
<li>Pays-Bas</li>
<li>Royaume-Uni</li>
</country>
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<li>Angleterre</li>
<li>Grand Londres</li>
<li>Lombardie</li>
<li>Nouvelle-Galles du Sud</li>
<li>Utrecht (province)</li>
<li>Victoria (État)</li>
<li>Île-de-France</li>
</region>
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<li>Londres</li>
<li>Melbourne</li>
<li>Milan</li>
<li>Paris</li>
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<name sortKey="Van Der Leeuw, Joep" sort="Van Der Leeuw, Joep" uniqKey="Van Der Leeuw J" first="Joep" last="Van Der Leeuw">Joep Van Der Leeuw</name>
</region>
<name sortKey="Grobbee, Diederick E" sort="Grobbee, Diederick E" uniqKey="Grobbee D" first="Diederick E" last="Grobbee">Diederick E. Grobbee</name>
<name sortKey="Van Der Graaf, Yolanda" sort="Van Der Graaf, Yolanda" uniqKey="Van Der Graaf Y" first="Yolanda" last="Van Der Graaf">Yolanda Van Der Graaf</name>
<name sortKey="Visseren, Frank L J" sort="Visseren, Frank L J" uniqKey="Visseren F" first="Frank L J" last="Visseren">Frank L J. Visseren</name>
</country>
<country name="Australie">
<region name="Nouvelle-Galles du Sud">
<name sortKey="Woodward, Mark" sort="Woodward, Mark" uniqKey="Woodward M" first="Mark" last="Woodward">Mark Woodward</name>
</region>
<name sortKey="Chalmers, John" sort="Chalmers, John" uniqKey="Chalmers J" first="John" last="Chalmers">John Chalmers</name>
<name sortKey="Harrap, Stephen" sort="Harrap, Stephen" uniqKey="Harrap S" first="Stephen" last="Harrap">Stephen Harrap</name>
<name sortKey="Zoungas, Sophia" sort="Zoungas, Sophia" uniqKey="Zoungas S" first="Sophia" last="Zoungas">Sophia Zoungas</name>
</country>
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<noRegion>
<name sortKey="Heller, Simon" sort="Heller, Simon" uniqKey="Heller S" first="Simon" last="Heller">Simon Heller</name>
</noRegion>
<name sortKey="Poulter, Neil" sort="Poulter, Neil" uniqKey="Poulter N" first="Neil" last="Poulter">Neil Poulter</name>
</country>
<country name="Italie">
<region name="Lombardie">
<name sortKey="Mancia, Giuseppe" sort="Mancia, Giuseppe" uniqKey="Mancia G" first="Giuseppe" last="Mancia">Giuseppe Mancia</name>
</region>
</country>
<country name="France">
<region name="Île-de-France">
<name sortKey="Marre, Michel" sort="Marre, Michel" uniqKey="Marre M" first="Michel" last="Marre">Michel Marre</name>
</region>
</country>
</tree>
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