Introduction: Dipeptidyl peptidase 4 inhibitors (DPP-4 inhibitors) are incretin-based oral antidiabetic drugs. Previous studies have shown an association between increased plasma activity of DPP-4 and chronic hepatitis C virus (HCV) infection. Dipeptidyl peptidase 4 inhibitors may be associated with preventing the development of chronic HCV infection. The aim of this study was to investigate whether the use of DPP-4 inhibitors is associated with a decreased risk of hepatocellular carcinoma (HCC) in patients with diabetes mellitus (DM) and chronic HCV infection.Methods: In this retrospective cohort study, we enrolled patients with type 2 diabetes and chronic HCV infection from the National Health Insurance Research Database (NHIRD) in Taiwan. The patients were divided into two groups (DPP-4 inhibitor cohort and non-DPP-4 inhibitor cohort) according to whether or not they received DPP-4 inhibitor treatment.Results: Multivariate Cox proportional hazard regression analysis showed a significantly lower risk of HCC in the patients who took DPP-4 inhibitors compared to those who did not. Kaplan-Meier survival analysis demonstrated a significantly higher HCC-free rate in the DPP-4 inhibitor cohort than in the non-DPP-4 inhibitor cohort.Conclusion: The use of DPP-4 inhibitors was associated with a lower risk of HCC in patients with type 2 DM and chronic HCV infection.
Diabetes mellitus (DM) is a chronic metabolic disease. If blood glucose is poorly controlled, it will cause a variety of chronic complications. Therefore, the issue of healthcare in diabetic patients is a problem that cannot be ignored. In this study, we aim to investigate the correlation between sociodemographic characteristics, self-management, and glycated hemoglobin (HbA1c) values in patients with type 2 diabetes treated with insulin. A total of 300 type 2 diabetic patients treated with insulin were enrolled. Type 2 diabetic patients treated with insulin had a significant negative correlation of HbA1c value to self-management total score. The lower the HbA1c value, the better the self-management of type 2 diabetic patients treated with insulin is. It is recommended that scale assessment tools be used to identify problems, improve the self-management ability of type 2 diabetic patients, and problem solve in patients in order to facilitate the effectiveness of blood glucose control of type 2 diabetic patients.
Diabetes mellitus has become a global pandemic and a major cause of death. Five million adults died from diabetes in 2017, accounting for 9.9% of all causes of mortality globally. 1 In Taiwan, diabetes was the fifth leading cause of death from 2016 to 2018, just behind malignancy, cardiovascular disease, pneumonia and cerebrovascular disease. 2 A nationwide survey in 2014 reported life expectancies of 39.6 and 33.4 years among women and men, respectively, in whom diabetes was diagnosed at the age of 40 years, which were 2.6 and 3.2 years less than in the general population. 3 It is well known that atherosclerotic cardiovascular disease (ASCVD) is the leading cause of mortality for individuals with diabetes. 4 Patients with macrovascular diseases are at increased risk of death caused by ASCVD due to the pre-existing atherosclerotic lesions; however, it is questionable whether the patients with microvascular disease are also at high risk for mortality from ASCVD. The aim of this study was to investigate the causes of in-hospital death of patients with type 2 diabetes with
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