Type 2 diabetes and increased CVD risk

Risk Factor Control and Cardiovascular Event Risk in People With Type 2 Diabetes in Primary and Secondary Prevention Settings
Circulation. 2020;142:1925–1936

• Analysis of the association between the degree of risk factor control and cardiovascular disease (CVD) risk in type 2 diabetes (T2D) using data from English practices from CPRD GOLD (Clinical Practice Research Datalink) and the SCI-Diabetes dataset (Scottish Care Information-Diabetes). It was found that optimally managed people with T2D have a 21% higher CVD risk when compared with controls. People with T2D without cardio-renal disease would be predicted to benefit greatly from CVD risk factor intervention.

Association of Type 2 Diabetes With Cancer: A Meta-analysis

Association of Type 2 Diabetes With Cancer: A Meta-analysis With Bias Analysis for Unmeasured Confounding in 151 Cohorts Comprising 32 Million People
Diabetes Care 2020 Sep; 43(9): 2313-2322.https://doi.org/10.2337/dc20-0204

• A total of 151 cohorts (over 32 million people, 1.1 million cancer cases, and 150,000 cancer deaths) were identified. In meta-analyses, type 2 diabetes (T2D) was associated with incidence of several cancers, from prostate (RR 0.83; 95% CI 0.79, 0.88) to liver (2.23; 1.99, 2.49), and with mortality from pancreatic cancer (1.67; 1.30, 2.14). In bias analyses, assuming an unmeasured confounding associated with both T2D and cancer with a RR of 1.5, the proportion of studies with a true effect size larger than a RR of 1.1 (i.e., 10% increased risk in individuals with T2D) was nearly 100% for liver, pancreatic, and endometrial, 86% for gallbladder, 67% for kidney, 64% for colon, 62% for colorectal, and <50% for other cancer incidences, and 92% for pancreatic cancer mortality.

Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis

Association between prediabetes and risk of all cause mortality and cardiovascular disease: updated meta-analysis
BMJ 2020; 370 :m2297 20 May 2020

An updated meta analysis (129 studies n=10 069 955 individuals) suggests that prediabetes is associated with an increased risk of all cause mortality and cardiovascular disease in the general population and in patients with atherosclerotic cardiovascular disease.

Abstract

What do healthcare professionals need to turn risk models for type 2 diabetes into usable computerized clinical decision support systems?

What do healthcare professionals need to turn risk models for type 2 diabetes into usable computerized clinical decision support systems? Lessons learned from the MOSAIC project.
BMC Med Inform Decis Mak. 2019 Aug 16;19(1):163. doi: 10.1186/s12911-019-0887-8.

• This research aims to understand user needs, system requirements and organizational conditions towards successful design and adoption of Clinical Decision Support Systems for Type 2 Diabetes care built on top of computerized risk models.

Decision Support for Diabetes in Scotland: Implementation and Evaluation of a Clinical Decision Support System

Decision Support for Diabetes in Scotland: Implementation and Evaluation of a Clinical Decision Support System
J Diabetes Sci Technol. 2018 Mar; 12(2): 381–388

• A clinical decision support system (CDSS) for diabetes introduced in two regions in Scotland was well received; associated with improved efficiencies in working practices; and large improvements in guideline adherence.

Abstract