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Insulin pump therap...
Insulin pump therapy, multiple daily injections, and cardiovascular mortality in 18 168 people with type 1 diabetes: observational study
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- Steineck, I. (författare)
- Department of Endocrinology, Aarhus University Hospital, Aarhus, Denmark
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- Cederholm, Jan (författare)
- Uppsala universitet,Allmänmedicin och preventivmedicin,Department of Public Health and Caring Sciences/Family and Preventive Medicine, Uppsala University, Uppsala, Sweden
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- Eliasson, Björn, 1959 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine,Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
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- Rawshani, Araz, 1986 (författare)
- National Diabetes Register, Centre of Registers Västra Götaland, Gothenburg, Sweden
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- Eeg-Olofsson, Katarina, 1968 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine,Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
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- Svensson, A. M. (författare)
- National Diabetes Register, Centre of Registers Västra Götaland, Gothenburg, Sweden
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- Zethelius, Björn (författare)
- Uppsala universitet,Geriatrik,Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden; Medical Products Agency, Uppsala, Sweden
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- Avdic, T. (författare)
- National Diabetes Register, Centre of Registers Västra Götaland, Gothenburg, Sweden
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- Landin-Olsson, Mona (författare)
- Lund University,Lunds universitet,Medicin, Lund,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Medicine, Lund,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Department of Clinical Science, Lund University, Lund, Sweden
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- Jendle, Johan, 1963- (författare)
- Örebro universitet,Institutionen för hälsovetenskap och medicin
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- Gudbjörnsdottir, Soffia, 1962 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine,Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden; National Diabetes Register, Centre of Registers Västra Götaland, Gothenburg, Sweden
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(creator_code:org_t)
- 2015-06-22
- 2015
- Engelska.
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Ingår i: Bmj-British Medical Journal. - : BMJ. - 1756-1833. ; 350
- Relaterad länk:
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https://www.bmj.com/...
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https://portal.resea... (primary) (free)
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http://www.ncbi.nlm.... (free)
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http://dx.doi.org/10... (free)
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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https://lup.lub.lu.s...
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https://urn.kb.se/re...
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https://urn.kb.se/re...
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Abstract
Ämnesord
Stäng
- OBJECTIVE To investigate the long term effects of continuous subcutaneous insulin infusion (insulin pump therapy) on cardiovascular diseases and mortality in people with type 1 diabetes. Design Observational study. 18 168 people with type 1 diabetes, 2441 using insulin pump therapy and 15 727 using multiple daily insulin injections. Cox regression analysis was used to estimate hazard ratios for the outcomes, with stratification of propensity scores including clinical characteristics, risk factors for cardiovascular disease, treatments, and previous diseases. Follow-up was for a mean of 6.8 years until December 2012, with 114 135 person years. With multiple daily injections as reference, the adjusted hazard ratios for insulin pump treatment were significantly lower: 0.55 (95% confidence interval 0.36 to 0.83) for fatal coronary heart disease, 0.58 (0.40 to 0.85) for fatal cardiovascular disease (coronary heart disease or stroke), and 0.73 (0.58 to 0.92) for all cause mortality. Hazard ratios were lower, but not significantly so, for fatal or non-fatal coronary heart disease and fatal or non-fatal cardiovascular disease. Unadjusted absolute differences were 3.0 events of fatal coronary heart disease per 1000 person years; corresponding figures were 3.3 for fatal cardiovascular disease and 5.7 for all cause mortality. When lower body mass index and previous cardiovascular diseases were excluded, results of subgroup analyses were similar to the results from complete data. A sensitivity analysis of unmeasured confounders in all individuals showed that an unmeasured confounders with hazard ratio of 1.3 would have to be present in > 80% of the individuals treated with multiple daily injections versus not presence in those treated with pump therapy to invalidate the significantly lower hazard ratios for fatal cardiovascular disease. Data on patient education and frequency of blood glucose monitoring were missing, which might have influenced the observed association. Among people with type 1 diabetes use of insulin pump therapy is associated with lower cardiovascular mortality than treatment with multiple daily insulin injections.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Allmänmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- General Practice (hsv//eng)
Nyckelord
- SEVERE HYPOGLYCEMIA
- GLYCEMIC CONTROL
- RADICAL PROSTATECTOMY
- MYOCARDIAL-INFARCTION
- INFUSION
- MELLITUS
- METAANALYSIS
- OUTCOMES
- DISEASE
- GLUCOSE
- Medicine
- General & Internal
- Family Medicine
Publikations- och innehållstyp
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- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Steineck, I.
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Cederholm, Jan
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Eliasson, Björn, ...
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Rawshani, Araz, ...
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Eeg-Olofsson, Ka ...
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Svensson, A. M.
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visa fler...
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Zethelius, Björn
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Avdic, T.
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Landin-Olsson, M ...
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Jendle, Johan, 1 ...
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Gudbjörnsdottir, ...
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- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kardiologi
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Endokrinologi oc ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Allmänmedicin
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Bmj-British Medi ...
- Av lärosätet
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Göteborgs universitet
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Lunds universitet
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Uppsala universitet
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Örebro universitet