Early insulin therapy is capable to achieve glycemic control and restoreβ-cell function in newly diagnosed type 2 diabetes(T2D),but its effect on cardiovascular outcomes in these patients remains unclear.In this nati...Early insulin therapy is capable to achieve glycemic control and restoreβ-cell function in newly diagnosed type 2 diabetes(T2D),but its effect on cardiovascular outcomes in these patients remains unclear.In this nationwide real-world study,we analyzed electronic health record data from 19 medical centers across China between 1 January 2000,and 26 May 2022.We included 5424 eligible patients(mean age 56 years,2176 women/3248 men)who were diagnosed T2D within six months and did not have prior cardiovascular disease.Multivariable Cox regression models were used to estimate the associations of early insulin therapy(defined as the first-line therapy for at least two weeks in newly diagnosed T2D patients)with the incidence of major cardiovascular events including coronary heart disease(CHD),stroke,and hospitalization for heart failure(HF).During 17,158 persons years of observation,we documented 834 incident CHD cases,719 stroke cases,and 230 hospitalized cases for HF.Newly diagnosed T2D patients who received early insulin therapy,compared with those who did not receive such treatment,had 31%lower risk of incident stroke,and 28%lower risk of hospitalization for HF.No significant difference in the risk of CHD was observed.We found similar results when repeating the aforesaid analysis in a propensity-score matched population of 4578 patients and with inverse probability of treatment weighting models.These findings suggest that early insulin therapy in newly diagnosed T2D may have cardiovascular benefits by reducing the risk of incident stroke and hospitalization for HF.展开更多
基金the National Key R&D Program of China(grant No.2021YFC2500501)the Strategic Priority Research Program of Chinese Academy of Sciences(grant no.XDB38010100)+4 种基金the National Natural Science Foundation of China(grant no.82030022 and 82330020)Program for Innovative Research Team of The First Affiliated Hospital of USTC(grant no.CXGG02)the Program of Introducing Talents of Discipline to Universities,111 Plan(grant no.D18005)Guangdong Provincial Clinical Research Center for Kidney Disease(2020B1111170013)Key Technologies R&D Program of Guangdong Province(grant no.2023B1111030004).
文摘Early insulin therapy is capable to achieve glycemic control and restoreβ-cell function in newly diagnosed type 2 diabetes(T2D),but its effect on cardiovascular outcomes in these patients remains unclear.In this nationwide real-world study,we analyzed electronic health record data from 19 medical centers across China between 1 January 2000,and 26 May 2022.We included 5424 eligible patients(mean age 56 years,2176 women/3248 men)who were diagnosed T2D within six months and did not have prior cardiovascular disease.Multivariable Cox regression models were used to estimate the associations of early insulin therapy(defined as the first-line therapy for at least two weeks in newly diagnosed T2D patients)with the incidence of major cardiovascular events including coronary heart disease(CHD),stroke,and hospitalization for heart failure(HF).During 17,158 persons years of observation,we documented 834 incident CHD cases,719 stroke cases,and 230 hospitalized cases for HF.Newly diagnosed T2D patients who received early insulin therapy,compared with those who did not receive such treatment,had 31%lower risk of incident stroke,and 28%lower risk of hospitalization for HF.No significant difference in the risk of CHD was observed.We found similar results when repeating the aforesaid analysis in a propensity-score matched population of 4578 patients and with inverse probability of treatment weighting models.These findings suggest that early insulin therapy in newly diagnosed T2D may have cardiovascular benefits by reducing the risk of incident stroke and hospitalization for HF.
