Prognostic cardiovascular risks in patients with type 2 diabetes mellitus depending on the type of hypoglycemic therapy
Abstract. Type 2 diabetes mellitus (T2DM) is an independent risk factor for cardiovascular diseases (CVD) arising, increasing the probability of coronary heart disease (CHD) development. However, prognostic cardiovascular risks in these kind of patients depending on the type of hypoglycemic therapy they are receiving are still poorly studied.G.A. Slonimskaya, I.A. Kurnikova, V.A. Kokorin, T.A. Meleshkevich, V.A. Mayorov, A.F. Pavlov
The aim: to access the prognostic cardiovascular risks in patients with T2DM depending on the type of antidiabetic therapy they received by odds ratio (OR) and relative risk (RR) calculation.
Material and methods. 112 patients with T2DM were examined, divided into three groups based on their therapy: Group 1 – patients on oral antihyperglycemic drugs (OADs, n = 41), Group 2 – patients on intensified insulin therapy (IIT, n = 38), and Group 3 – patients on continuous subcutaneous insulin infusion (CSII, n = 33). Study participants underwent clinical and laboratory examinations, 24-hour blood pressure monitoring, and Holter electrocardiogram monitoring. OR and RR for developing CHD were calculated.
Results. CHD was diagnosed in 73.2% of patients in the OADs group, 65.8% in the IIT group, and 38% in the CSII group. The OR for developing CHD in patients from OADs group was 4.77 (95% CI: 1.77–12.85) and 3.37 (95% CI: 1.27–8.93) in the IIT group comparatively with CSII group. Switching to CSII was associated with a 47% reduction in the relative risk of CHD occurence.
Conclusion. CSII has the greatest cardioprotective potential among the compared hypoglycemic therapy variants in patients with T2DM.
Keywords
type 2 diabetes mellitus
cardiovascular risk
odds ratio
hazard ratio
glycemic variability
coronary heart disease
continuous subcutaneous insulin infusion
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About the Authors
Galina A. Slonimskaya, MD, endocrinologist at Clinical and Diagnostic Center of outpatient clinic, Federal Budgetary Medical and Social Expertise Center; postgraduate student of the Medical Institute, RUDN University, Moscow, Russian Federation.E-mail: dr.slonimskaya@gmail.com
ORCID: https://orcid.org/0000-0002-8283-5890. eLibrary SPIN: 7498-6081
Irina A. Kurnikova, MD, Dr. Sci. (Medicine), professor of the Department of hospital therapy with courses in endocrinology, hematology, and clinical laboratory diagnostics of the Medical Institute, RUDN University, Moscow, Russian Federation.
E-mail: curnikova@yandex.ru
ORCID: https://orcid.org/0000-0002-5712-9679. Scopus ID: 57194274080. eLibrary SPIN: 8579-9455
Valentin A. Kokorin, MD, Dr. Sci. (Medicine), professor, head of the Department of hospital therapy with courses in endocrinology, hematology, and clinical laboratory diagnostics of the Medical Institute, RUDN University, Moscow, Russian Federation.
E-mail: kokorin_va@rudn.ru
ORCID: https://orcid.org/0000-0001-8614-6542. Scopus ID: 56053021100. eLibrary SPIN: 9772-2288
Tatiana A. Meleshkevich, MD, Dr. Sci. (Medicine), associate professor of the Department of hospital therapy with courses in endocrinology, hematology, and clinical laboratory diagnostics of the Medical Institute, RUDN University, Moscow, Russian Federation.
E-mail: samson2012@yandex.ru
ORCID: https://orcid.org/0000-0003-3229-3357. Scopus ID: 36140675500. eLibrary SPIN: 5839-5281.
Vladimir A. Mayorov, MD, postgraduate student of the Department of hospital therapy with courses in endocrinology, hematology, and clinical laboratory diagnostics of the Medical Institute, RUDN University, Moscow, Russian Federation.
E-mail: maikvova@gmail.com
ORCID: https://orcid.org/0000-0001-8227-5558
Alexey F. Pavlov, MD, postgraduate student of the Department of hospital therapy with courses in endocrinology, hematology, and clinical laboratory diagnostics of the Medical Institute, RUDN University, Moscow, Russian Federation.
E-mail: Dr. A. Pavlov2018@gmail.ru
ORCID: https://orcid.org/0000-0001-8406-0390
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