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Achievement of Treatment Goals and Mortality in Individuals with Diabetes: The ELSA-Brasil Study.
Chwal, Bruna Cristine; Dos Reis, Rodrigo Citton P; Schmidt, Maria Inês; Barreto, Sandhi Maria; Griep, Rosane Harter; Duncan, Bruce B.
Afiliación
  • Chwal BC; Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos, 2600/518, Porto Alegre CEP 90035-003, Brazil.
  • Dos Reis RCP; Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos, 2600/518, Porto Alegre CEP 90035-003, Brazil.
  • Schmidt MI; Departamento de Estatística, Universidade Federal do Rio Grande do Sul, Porto Alegre CEP 90040-060, Brazil.
  • Barreto SM; Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, R. Ramiro Barcelos, 2600/518, Porto Alegre CEP 90035-003, Brazil.
  • Griep RH; Hospital de Clínicas de Porto Alegre, Porto Alegre CEP 90035-903, Brazil.
  • Duncan BB; Faculdade de Medicina e Hospital das Clínicas/EBSERH, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte CEP 31270-901, Brazil.
J Clin Med ; 12(24)2023 Dec 13.
Article en En | MEDLINE | ID: mdl-38137733
ABSTRACT

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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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE País/Región como asunto: America do sul / Brasil Idioma: En Revista: J Clin Med Año: 2023 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE País/Región como asunto: America do sul / Brasil Idioma: En Revista: J Clin Med Año: 2023 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Suiza