Key result
The use of sulfonylurea or insulin was associated with a significantly increased 5-year risk of coronary heart disease (HR 5.6) in Japanese patients with type 2 diabetes.
Why the study?
Under post-Kumamoto Declaration 2013 diabetes treatment policy, accurately predicting complication incidence with the JJ risk engine is difficult.
Does a new prediction equation incorporating sulfonylurea or insulin use accurately predict the 5-year incidence of coronary heart disease in Japanese patients with type 2 diabetes?
Observational (n=857)
Yes
Does a new prediction equation incorporating sulfonylurea or insulin use accurately predict the 5-year incidence of coronary heart disease in Japanese patients with type 2 diabetes?
Effect estimate: HR 5.6 (95% CI 1.3-24.8)
p-value: p=<0.05
A newly developed prediction equation incorporating sulfonylurea or insulin use demonstrated moderate accuracy in predicting the 5-year incidence of coronary heart disease in Japanese patients with type 2 diabetes.
Sulfonylurea or insulin use signals higher CHD risk in Japanese T2D; observational data leave open causality and should not guide therapy changes.
Objective: In the diabetes treatment policy after the Kumamoto Declaration 2013, it is difficult to accurately predict the incidence of complications in patients using the JJ risk engine. This study was conducted to develop a prediction equation suitable for the current diabetes treatment policy using patient data from Kitasato Institute Hospital (Hospital A) and to externally validate the developed equation using patient data from Kitasato University Hospital (Hospital B). Outlier tests were performed on the patient data from Hospital A to exclude the outliers. Prediction equation was developed using the patient data excluding the outliers and was subjected to external validation. Results: By excluding outlier data, we were able to develop a new prediction equation for the incidence of coronary heart disease (CHD) as a complication of type 2 diabetes, incorporating the use of antidiabetic drugs with a high risk of hypoglycemia. This is the first prediction equation in Japan that incorporates the use of antidiabetic drugs. We believe that it will be useful in preventive medicine for treatment for people at high risk of CHD as a complication of diabetes or other diseases. In the future, we would like to confirm the accuracy of this equation at other facilities.
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Yamashita et al. (2021) conducted an observational in Type 2 diabetes (n=857). Sulfonylurea and/or insulin vs. Neither sulfonylurea nor insulin was evaluated on Incidence of coronary heart disease (CHD) (HR 5.6, 95% CI 1.3-24.8, p=<0.05). The use of sulfonylurea or insulin was associated with a significantly increased 5-year risk of coronary heart disease (HR 5.6) in Japanese patients with type 2 diabetes.
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