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Clinical analysis of risk factors for severe COVID-19 patients with type 2 diabetes.
Zhang, Q, Wei, Y, Chen, M, Wan, Q, Chen, X
Journal of diabetes and its complications. 2020;(10):107666
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Abstract
AIMS: To describe characteristics of COVID-19 patients with type 2 diabetes and to analyze risk factors for severity. METHODS Demographics, comorbidities, symptoms, laboratory findings, treatments and outcomes of COVID-19 patients with diabetes were collected and analyzed. RESULTS Seventy-fourCOVID-19 patients with diabetes were included. Twenty-seven patients (36.5%) were severe and 10 patients (13.5%) died. Higher levels of blood glucose, serum amyloid A (SAA), C reactive protein and interleukin 6 were associated with severe patients compared to non-severe ones (P<0.05). Levels of albumin, cholesterol, high density lipoprotein, small and dense low density lipoprotein and CD4+T lymphocyte counts in severe patients were lower than those in non-severe patients (P<0.05). Logistic regression analysis identified decreased CD4+T lymphocyte counts (odds ratio [OR]=0.988, 95%Confidence interval [95%CI] 0.979-0.997) and increased SAA levels (OR=1.029, 95%CI 1.002-1.058) as risk factors for severity of COVID-19 with diabetes (P<0.05). CONCLUSIONS Type 2 diabetic patients were more susceptible to COVID-19 than overall population, which might be associated with hyperglycemia and dyslipidemia. Aggressive treatment should be suggested, especially when these patients had low CD4+T lymphocyte counts and high SAA levels.
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Comparative effectiveness of sodium-glucose co-transporter 2 inhibitors for controlling hyperglycaemia in patients with type 2 diabetes: protocol for a systematic review and network meta-analysis.
Chen, M, Xie, CG, Gao, H, Zheng, H, Chen, Q, Fang, JQ
BMJ open. 2016;(1):e010252
Abstract
INTRODUCTION As a new class of glucose-lowering drugs, sodium-glucose co-transporter 2 (SGLT2) inhibitors are effective for controlling hyperglycaemia, however, the relative effectiveness and safety of 6 recently available SGLT2 inhibitors have rarely been studied. Therefore, we aim to perform pairwise comparisons of the 6 SGLT2 inhibitors. METHODS AND ANALYSIS A systematic review and network meta-analysis will be conducted. Clinical studies that examine effectiveness and safety of either canagliflozin, dapagliflozin, empagliflozin, ipragliflozin, tofogliflozin or luseogliflozin will be included. These studies will be systematically retrieved in MEDLINE, EMBASE and the Cochrane Library, from inception to November 2015. Two reviewers will independently screen for eligible studies and then extract data from the studies as well as assess risk of bias. Discrepancies in screening and data extraction will be arbitrated by a third reviewer. A traditional meta-analysis will be performed to combine the effect sizes calculated from head-to-head comparisons with a random effect model. The effect sizes computed from indirect comparisons will be further combined in a network meta-analysis. Heterogeneity will be tested with the Cochrane's Q statistic, and publication bias will be assessed using a funnel plot and the Egger's test. ETHICS AND DISSEMINATION Relative effectiveness and harms of the 6 SGLT2 inhibitors will be demonstrated through this systematic review and network meta-analysis. The result of the review will be disseminated through a peer-review journal and conference presentations. Patients, clinicians and policymakers will benefit from this review in selecting a SGLT2 inhibitor for glucose control in patients with type 2 diabetes. TRIAL REGISTRATION NUMBER PROSPERO CRD42015025981.
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Association of SLC30A8 gene polymorphism with type 2 diabetes, evidence from 46 studies: a meta-analysis.
Fan, M, Li, W, Wang, L, Gu, S, Dong, S, Chen, M, Yin, H, Zheng, J, Wu, X, Jin, J, et al
Endocrine. 2016;(2):381-94
Abstract
The solute carrier family 30 member 8 (SLC30A8) gene may be involved in the development of type 2 diabetes mellitus (T2DM) through disrupting β-cell function. The aim of this study was to assess the association between SLC30A8 rs13266634 polymorphism and susceptibility to T2DM. We searched all reports regarding the association between SLC30A8 rs13266634 polymorphism and T2DM risk through Pubmed, Embase, and the Cochrane Library for English language reports and Chongqing VIP database, Wanfang data, CBMDisc, and CNKI for Chinese language studies. Allelic and genotype comparisons between cases and controls were evaluated, and odds ratios with 95 % confidence intervals were used to assess the strength of their association. A random effects model was selected. Publication bias was estimated using Begg's test. Forty-six studies were included in the analysis with a total of 71,890 cases and 96,753 controls. This meta-analysis suggests that SLC30A8 (rs13266634) polymorphism was associated with T2DM risk. Although previous meta-analyses have shown that this association was only found in Asian and European groups, and not in African populations, our analysis revealed the deleterious effect of SLC30A8 rs13266634 on T2DM in an African population when stratified by ethnicity under additive model even with a small number of studies.
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Caffeinated and decaffeinated coffee consumption and risk of type 2 diabetes: a systematic review and a dose-response meta-analysis.
Ding, M, Bhupathiraju, SN, Chen, M, van Dam, RM, Hu, FB
Diabetes care. 2014;(2):569-86
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Abstract
OBJECTIVE Previous meta-analyses identified an inverse association of coffee consumption with the risk of type 2 diabetes. However, an updated meta-analysis is needed because new studies comparing the trends of association for caffeinated and decaffeinated coffee have since been published. RESEARCH DESIGN AND METHODS PubMed and Embase were searched for cohort or nested case-control studies that assessed the relationship of coffee consumption and risk of type 2 diabetes from 1966 to February 2013. A restricted cubic spline random-effects model was used. RESULTS Twenty-eight prospective studies were included in the analysis, with 1,109,272 study participants and 45,335 cases of type 2 diabetes. The follow-up duration ranged from 10 months to 20 years. Compared with no or rare coffee consumption, the relative risk (RR; 95% CI) for diabetes was 0.92 (0.90-0.94), 0.85 (0.82-0.88), 0.79 (0.75-0.83), 0.75 (0.71-0.80), 0.71 (0.65-0.76), and 0.67 (0.61-0.74) for 1-6 cups/day, respectively. The RR of diabetes for a 1 cup/day increase was 0.91 (0.89-0.94) for caffeinated coffee consumption and 0.94 (0.91-0.98) for decaffeinated coffee consumption (P for difference = 0.17). CONCLUSIONS Coffee consumption was inversely associated with the risk of type 2 diabetes in a dose-response manner. Both caffeinated and decaffeinated coffee was associated with reduced diabetes risk.
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Glucose metabolism among residents in Shanghai: natural outcome of a 5-year follow-up study.
Qian, Q, Li, X, Huang, X, Fu, M, Meng, Z, Chen, M, Feng, B
Journal of endocrinological investigation. 2012;(5):453-8
Abstract
BACKGROUND Previous studies have shown that Type 2 diabetes mellitus (T2DM) is usually preceded by a condition known as pre-diabetes. However, few studies evaluate the rate of each status of impaired glucose regulation progressed to T2DM and its related metabolic disorders impacting the development. AIM: To investigate the natural outcome of glucose metabolism among Shanghai adult residents during a 5-yr period, and estimate the metabolic characteristics related with the conversion of glucose tolerance. SUBJECTS AND METHODS A cross-sectional survey with multiple- stage and random sampling was conducted among 1869 adult residents from Shanghai Pudong New District in 2002. In 2007, 1042 non-diabetic subjects were successfully followed up. All the participants completed a questionnaire and underwent anthropometric measurements and a 75-g oral glucose tolerance test. RESULTS The incidence of diabetes was higher in isolated impaired glucose tolerance (i- IGT), isolated impaired fasting glucose (i-IFG), and combined fasting and post-prandial hyperglycemia (IFG/IGT) group when compared to that in normal glucose tolerance group, as relative ratios with 95% confidence intervals of 9.2 (5.5- 15.2), 7.5 (3.6-15.7), and 13.2 (5.8-30.2), respectively. Subjects who had 2 or more metabolic disorders had a 2-3-fold higher incidence than those with less than 1 metabolic disorder (all p<0.001). CONCLUSIONS People with pre-diabetes are at increased risk of diabetes, suggesting the need for frequent screening in theloe people with several metabolic disorders.