Assessment of cardiometabolic risk and prevalence of meeting treatment guidelines among patients with type 2 diabetes stratified according to their use of insulin and/or other diabetic medications: results from INSPIRE ME IAA.

Abstract

AIM:

Visceral adipose tissue (VAT) and liver fat (LF) are strongly associated with type 2 diabetes. It is not known, however, how diabetes treatment and/or risk factor management modulates the association between VAT, LF and diabetes. The aim was to determine the level of VAT and LF in patients with type 2 diabetes according to their treatment status and achievement of the American Diabetes Association's (ADA) diabetes management goals.

METHODS:

We performed a cross-sectional analysis of the baseline data of the International Study of the Prediction of Intra-Abdominal Adiposity and its Relationship with Cardiometabolic risk/Intra-Abdominal Adiposity (INSPIRE ME IAA), a 3-year prospective cardiometabolic imaging study conducted in 29 countries. Patients (n = 3991) were divided into four groups: (i) those without type 2 diabetes (noT2D n = 1003 men, n = 1027 women); (ii) those with type 2 diabetes but not treated with diabetes medications (T2Dnomeds n = 248 men, n = 198 women); (iii) those with type 2 diabetes and treated with diabetes medications but not yet using insulin (T2Dmeds-ins n = 591 men, n = 484 women) and (iv) those with type 2 diabetes and treated with insulin (T2Dmeds+ins n = 233 men, n = 207 women). Abdominal and liver adiposity were measured by computed tomography.

RESULTS:

Fewer patients with high VAT or LF achieved the ADA's goals for high-density lipoprotein cholesterol (HDL-C) or triglycerides compared to patients with low VAT or LF. Visceral adiposity (p = 0.02 men, p = 0.003 women) and LF (p = 0.0002 men, p = 0.0004 women) increased among patients who met fewer of the ADA treatment criteria, regardless of type 2 diabetes treatment.

CONCLUSION:

Residual cardiometabolic risk exists among patients with type 2 diabetes characterized by elevated VAT and LF.

• Authors: J Smith, J-A Nazare, A-L Borel, P Aschner, P J Barter, L Van Gaal, Y Matsuzawa, T Kadowaki, R Ross, C Brulle-Wohlhueter, N Alméras, S M Haffner, B Balkau, J-P Després
• Journal: Diabetes, obesity & metabolism (Diabetes Obes Metab) Vol. 15 Issue 7 Pg. 629-41 (Jul 2013) ISSN: 1463-1326 [Electronic] England
• PMID: 23356633 (Publication Type: Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: © 2013 Blackwell Publishing Ltd.

Chemical References

• Hypoglycemic Agents
• Insulin

Topics

• Adiposity
• Adult
• Aged
• Cohort Studies
• Combined Modality Therapy
• Cross-Sectional Studies
• Diabetes Mellitus, Type 2 (blood, drug therapy, pathology, therapy)
• Drug Therapy, Combination
• Female
• Humans
• Hyperlipidemias (etiology, prevention & control)
• Hypoglycemic Agents (therapeutic use)
• Insulin (therapeutic use)
• Intra-Abdominal Fat (diagnostic imaging, pathology)
• Lipid Metabolism
• Liver (diagnostic imaging, pathology)
• Male
• Medication Adherence
• Metabolic Syndrome (epidemiology, physiopathology, prevention & control)
• Middle Aged
• Practice Guidelines as Topic
• Radiography
• Risk Factors