Weight change and microvascular outcomes in patients with new-onset diabetes: a nationwide cohort study

Koh, Eun Sil; Han, Kyung Do; Kim, Mee Kyoung; Kim, Eun Sook; Lee, Min Kyung; Nam, Ga Eun; Kwon, Hyuk Sang

doi:10.3904/kjim.2020.121

Cited by 11 publications

(11 citation statements)

References 42 publications

(57 reference statements)

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“…Hypertension was defined based on diagnostic ICD‐10 codes (I10‐13 or I15) and at least one claim/year for antihypertensive medication or systolic/diastolic blood pressure ≥140/90 mmHg 25 . Dyslipidemia was defined based on diagnostic codes (E78) and at least one claim/year for a lipid‐lowering agent or total cholesterol ≥240 mg/dL 25 , 26 . CVD was defined as diagnostic codes of I21‐22 or I63‐64 25 , 26 .…”

Section: Methodsmentioning

confidence: 99%

“…Dyslipidemia was defined based on diagnostic codes (E78) and at least one claim/year for a lipid‐lowering agent or total cholesterol ≥240 mg/dL 25 , 26 . CVD was defined as diagnostic codes of I21‐22 or I63‐64 25 , 26 . All types of cancer, liver cirrhosis and end‐stage renal disease were also identified using the ICD‐10 codes, and then excluded 25 , 26 .…”

Section: Methodsmentioning

confidence: 99%

“…CVD was defined as diagnostic codes of I21‐22 or I63‐64 25 , 26 . All types of cancer, liver cirrhosis and end‐stage renal disease were also identified using the ICD‐10 codes, and then excluded 25 , 26 . The estimated glomerular filtration rate (eGFR) was calculated from serum creatinine using the Modification of Diet in Renal Disease Study Group equation 27 .…”

Section: Methodsmentioning

confidence: 99%

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Adherence to healthy lifestyle behaviors as a preventable risk factor for severe hypoglycemia in people with type 2 diabetes: A longitudinal nationwide cohort study

Yun

Han

Park

et al. 2022

J of Diabetes Invest

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Aims/Introduction We investigated the associations between a combination of lifestyle factors and changes to these factors and the subsequent risk of severe hypoglycemia (SH) in type 2 diabetes patients. Materials and Methods Individuals with adult type 2 diabetes who underwent consecutive 2‐year interval health screening programs from 2009 to 2012 from the Korean National Health Insurance Service database were included and followed up until 2018. Information on history of smoking status, alcohol consumption and physical activity, as well as changes to these factors, was obtained. The primary outcome was incident SH. Results Of the 1,490,233 type 2 diabetes patients, 30,539 (2.1%) patients developed SH. Current smokers and heavy drinkers had increased risk of SH, compared with non‐smokers and non‐drinkers, respectively (hazard ratio 1.28, 95% confidence interval 1.23–1.34; hazard ratio 1.22, 95% confidence interval 1.15–1.30). However, regular physical activity was associated with reduced SH risk (hazard ratio 0.79, 95% confidence interval 0.77–0.82). A combination of unhealthy lifestyle habits was associated with increased SH risk in a dose‐dependent fashion (P for trend <0.001). Compared with participants without changes in their unhealthy lifestyles, participants who improved lifestyles had decreased risk of SH. Conclusions Greater adherence to healthy lifestyle factors and any improvement in unhealthy lifestyle habits were associated with a substantially lower risk of SH in individuals with type 2 diabetes.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Adherence to healthy lifestyle behaviors as a preventable risk factor for severe hypoglycemia in people with type 2 diabetes: A longitudinal nationwide cohort study

Yun

Han

Park

et al. 2022

J of Diabetes Invest

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“…CKD was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min•1.73 m 2 , calculated using the CKD Epidemiology Collaboration (EPI) equation 9 .…”

Section: Definition Of T2dm Comorbidities and Clinical Parametersmentioning

confidence: 99%

Uncontrolled hypertension is associated with an increased risk of end-stage renal disease in patients with type 2 diabetes who underwent postpercutaneous coronary intervention: A nationwide population-based study

Kim,

Park,

et al. 2024

Preprint

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Background: Little is known about the use of hypertension to predict end-stage renal disease (ESRD) in patients with type 2 diabetes mellitus (T2DM) and established coronary artery disease who underwent percutaneous coronary intervention (PCI). Here, we evaluated the effect of differential blood pressure (BP) levels on future ESRD in this population. Methods: Using nationwide health check-up data from the Korean National Health Insurance Service between 2015 and 2016, we obtained data for 80,187 patients with T2DM who underwent previous PCI. Patients were classified into four groups according to BP level measured within at least 2 years after PCI: systolic BP <120 (reference), <130, <140, <160, and ≥160 mm Hg; diastolic BP <80 (reference), <90, <100, and ≥100 mm Hg. The primary outcome was incident ESRD, defined as a combination of the relevant disease code and the initiation of renal replacement therapy. Multivariate Cox proportional hazard regression analysis was used to estimate the adjusted hazard ratio (HR) (95% CI) according to BP group. Results: The mean age was 67.7 years, and 80.9% of the participants were treated with antihypertensive medication. ESRD occurred in 1,362 (1.70%) patients during the 4.7-year follow-up. After adjustment for confounding factors, the HR of ESRD patients significantly and sequentially increased in the higher BP groups. Similar findings were noted regarding the relationship between incident ESRD and pulse pressure (PP). According to the subgroup analysis, this relationship was more significant for SBP in those aged <65 years than in those who were aged 65 years or older (P for interaction=0.0498). ESRD risk was linearly associated with systolic BP and had a J-shaped association with diastolic BP in patients with baseline values of 70 and 68 mm Hg. Conclusions: In this nationwide population-based study, elevated systolic and diastolic BP and PP were associated with the risk of developing ESRD in a dose–response manner among T2DM patients who underwent PCI. To prevent ESRD, more strict BP control is needed in T2DM patients who underwent PCI. Keywords: Diabetes mellitus; Korean National Health Insurance Service; ESRD; PCI

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“…The body weight fluctuation has been associated with increased cardiovascular events and mortality in the general population and patients with CKD as well as patients with DM [ 7 , 8 , 9 ]. A recent national cohort study found that weight change was associated with increased risks of myocardial infarction (MI), stroke, and death from any cause in people with type 2 DM [ 10 , 11 ], but the effect of weight change on ESRD has not yet been studied in patients with DM.…”

Section: Introductionmentioning

confidence: 99%

Underweight and Weight Change Increases End-Stage Renal Disease Risk in Patients with Diabetes: A Nationwide Population-Based Cohort Study

Bae

Suh

et al. 2021

Nutrients

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Weight variability has known as a risk factor for cardiovascular events and mortality. However, its effect on end-stage renal disease (ESRD) development remains controversial. We investigated the relationship between weight change and ESRD risk. Overall, 97,029 patients with DM aged >20 years were selected from the Korean National Health Screening Program 2009–2012. Weight change was defined as differences in body weight from the index year to 2 years later. Newly diagnosed ESRD was observed until 2017 end. Over a 5.1-year median follow-up period, ESRD was newly diagnosed in 7932 (4.81%) DM patients. BMI < 18.5 kg/m2 and waist circumferences <85/80 and >100/95 cm were ESRD risk factors. ESRD risk increased with increasing weight change; ≥10% weight loss (hazard ratio [HR], 1.247) followed by ≥10% weight gain (1.247) was associated with a higher HR than ≤5% weight change after adjusting for several confounding factors. The association between weight change and ESRD risk in a subgroup analysis was significantly stronger in patients aged <65 years, without proteinuria, with BMI ≥ 25, with DM duration <5 years, and prescribed less than 3 classes of DM medication. Underweight patients showed higher ESRD risks than overweight patients. Weight loss >10% was associated with the fastest decline in renal function.

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Weight change and microvascular outcomes in patients with new-onset diabetes: a nationwide cohort study

Cited by 11 publications

References 42 publications

Adherence to healthy lifestyle behaviors as a preventable risk factor for severe hypoglycemia in people with type 2 diabetes: A longitudinal nationwide cohort study

Adherence to healthy lifestyle behaviors as a preventable risk factor for severe hypoglycemia in people with type 2 diabetes: A longitudinal nationwide cohort study

Uncontrolled hypertension is associated with an increased risk of end-stage renal disease in patients with type 2 diabetes who underwent postpercutaneous coronary intervention: A nationwide population-based study

Underweight and Weight Change Increases End-Stage Renal Disease Risk in Patients with Diabetes: A Nationwide Population-Based Cohort Study

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