Achievement of treatment goals and mortality in individuals with diabetes : the ELSA-Brasil study
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/271757 |
Resumo: | Background: To prevent diabetes complications, the American Diabetes Association (ADA) has recommended the treatment of blood glucose, blood pressure, and LDL-cholesterol (LDL-c) to target levels. Our aim is to characterize the risk of death according to the achievement of these goals in subjects with diabetes participating in the ELSA-Brasil study. Methods: ELSA-Brasil is an occupational cohort study of middle-aged and elderly adults followed from a 2008–2010 baseline to 2019 by two additional clinic visits and annual telephone interviews. We ascertained known diabetes by self-reported diagnosis or anti-diabetic medication use. We used treatment targets based on the 2022 ADA guidelines. We ascertained deaths from any cause based on the annual surveillance confirmed by death certificates. Results: After 11 (1.8) years of follow-up, 261 subjects had died among 2423 with known diabetes. Within-target HbA1c was associated with the greatest protection (HR = 0.66; 95%CI 0.50–0.88) against all-cause mortality. Achieving both glycemic and blood pressure targets conferred substantial protection (HR = 0.54; 95%CI 0.37–0.78). Within-target LDL-c, however, was associated with increased mortality (HR = 1.44; 95%CI 1.11–1.88). Conclusions: Glucose and blood pressure control, especially when concomitant, reduced mortality. The increased mortality associated with achieving the LDL-c target merits further investigation. |
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Chwal, Bruna CristineReis, Rodrigo Citton Padilha dosSchmidt, Maria InêsBarreto, Sandhi MariaGriep, Rosane HarterDuncan, Bruce Bartholow2024-02-09T05:06:23Z20232077-0383http://hdl.handle.net/10183/271757001193458Background: To prevent diabetes complications, the American Diabetes Association (ADA) has recommended the treatment of blood glucose, blood pressure, and LDL-cholesterol (LDL-c) to target levels. Our aim is to characterize the risk of death according to the achievement of these goals in subjects with diabetes participating in the ELSA-Brasil study. Methods: ELSA-Brasil is an occupational cohort study of middle-aged and elderly adults followed from a 2008–2010 baseline to 2019 by two additional clinic visits and annual telephone interviews. We ascertained known diabetes by self-reported diagnosis or anti-diabetic medication use. We used treatment targets based on the 2022 ADA guidelines. We ascertained deaths from any cause based on the annual surveillance confirmed by death certificates. Results: After 11 (1.8) years of follow-up, 261 subjects had died among 2423 with known diabetes. Within-target HbA1c was associated with the greatest protection (HR = 0.66; 95%CI 0.50–0.88) against all-cause mortality. Achieving both glycemic and blood pressure targets conferred substantial protection (HR = 0.54; 95%CI 0.37–0.78). Within-target LDL-c, however, was associated with increased mortality (HR = 1.44; 95%CI 1.11–1.88). Conclusions: Glucose and blood pressure control, especially when concomitant, reduced mortality. The increased mortality associated with achieving the LDL-c target merits further investigation.application/pdfengJournal of Clinical Medicine. Basel. Vol. 12, n. 24 (2023), Art. 7663Diabetes mellitusFatores de risco cardiometabólicoMortalidadeHemoglobina A glicadaHipertensãoHipercolesterolemiaCardiometabolic risk factorsMortalityGlycated hemoglobin AHypertensionHypercholesterolemiaSmokingAchievement of treatment goals and mortality in individuals with diabetes : the ELSA-Brasil studyEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001193458.pdf.txt001193458.pdf.txtExtracted Texttext/plain62917http://www.lume.ufrgs.br/bitstream/10183/271757/2/001193458.pdf.txtc9c9a0ed295d0caf270e8fbcddfdc145MD52ORIGINAL001193458.pdfTexto completo (inglês)application/pdf935754http://www.lume.ufrgs.br/bitstream/10183/271757/1/001193458.pdf8a1501c2b8a01b2003e9146b01dbaf0aMD5110183/2717572024-02-10 06:07:28.406278oai:www.lume.ufrgs.br:10183/271757Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2024-02-10T08:07:28Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Achievement of treatment goals and mortality in individuals with diabetes : the ELSA-Brasil study |
title |
Achievement of treatment goals and mortality in individuals with diabetes : the ELSA-Brasil study |
spellingShingle |
Achievement of treatment goals and mortality in individuals with diabetes : the ELSA-Brasil study Chwal, Bruna Cristine Diabetes mellitus Fatores de risco cardiometabólico Mortalidade Hemoglobina A glicada Hipertensão Hipercolesterolemia Cardiometabolic risk factors Mortality Glycated hemoglobin A Hypertension Hypercholesterolemia Smoking |
title_short |
Achievement of treatment goals and mortality in individuals with diabetes : the ELSA-Brasil study |
title_full |
Achievement of treatment goals and mortality in individuals with diabetes : the ELSA-Brasil study |
title_fullStr |
Achievement of treatment goals and mortality in individuals with diabetes : the ELSA-Brasil study |
title_full_unstemmed |
Achievement of treatment goals and mortality in individuals with diabetes : the ELSA-Brasil study |
title_sort |
Achievement of treatment goals and mortality in individuals with diabetes : the ELSA-Brasil study |
author |
Chwal, Bruna Cristine |
author_facet |
Chwal, Bruna Cristine Reis, Rodrigo Citton Padilha dos Schmidt, Maria Inês Barreto, Sandhi Maria Griep, Rosane Harter Duncan, Bruce Bartholow |
author_role |
author |
author2 |
Reis, Rodrigo Citton Padilha dos Schmidt, Maria Inês Barreto, Sandhi Maria Griep, Rosane Harter Duncan, Bruce Bartholow |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Chwal, Bruna Cristine Reis, Rodrigo Citton Padilha dos Schmidt, Maria Inês Barreto, Sandhi Maria Griep, Rosane Harter Duncan, Bruce Bartholow |
dc.subject.por.fl_str_mv |
Diabetes mellitus Fatores de risco cardiometabólico Mortalidade Hemoglobina A glicada Hipertensão Hipercolesterolemia |
topic |
Diabetes mellitus Fatores de risco cardiometabólico Mortalidade Hemoglobina A glicada Hipertensão Hipercolesterolemia Cardiometabolic risk factors Mortality Glycated hemoglobin A Hypertension Hypercholesterolemia Smoking |
dc.subject.eng.fl_str_mv |
Cardiometabolic risk factors Mortality Glycated hemoglobin A Hypertension Hypercholesterolemia Smoking |
description |
Background: To prevent diabetes complications, the American Diabetes Association (ADA) has recommended the treatment of blood glucose, blood pressure, and LDL-cholesterol (LDL-c) to target levels. Our aim is to characterize the risk of death according to the achievement of these goals in subjects with diabetes participating in the ELSA-Brasil study. Methods: ELSA-Brasil is an occupational cohort study of middle-aged and elderly adults followed from a 2008–2010 baseline to 2019 by two additional clinic visits and annual telephone interviews. We ascertained known diabetes by self-reported diagnosis or anti-diabetic medication use. We used treatment targets based on the 2022 ADA guidelines. We ascertained deaths from any cause based on the annual surveillance confirmed by death certificates. Results: After 11 (1.8) years of follow-up, 261 subjects had died among 2423 with known diabetes. Within-target HbA1c was associated with the greatest protection (HR = 0.66; 95%CI 0.50–0.88) against all-cause mortality. Achieving both glycemic and blood pressure targets conferred substantial protection (HR = 0.54; 95%CI 0.37–0.78). Within-target LDL-c, however, was associated with increased mortality (HR = 1.44; 95%CI 1.11–1.88). Conclusions: Glucose and blood pressure control, especially when concomitant, reduced mortality. The increased mortality associated with achieving the LDL-c target merits further investigation. |
publishDate |
2023 |
dc.date.issued.fl_str_mv |
2023 |
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2024-02-09T05:06:23Z |
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Estrangeiro info:eu-repo/semantics/article |
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001193458 |
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Journal of Clinical Medicine. Basel. Vol. 12, n. 24 (2023), Art. 7663 |
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