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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
Author(s) -
Smith J.,
Nazare J.A.,
Borel A.L.,
Aschner P.,
Barter P. J.,
Van Gaal L.,
Matsuzawa Y.,
Kadowaki T.,
Ross R.,
BrulleWohlhueter C.,
Alméras N.,
Haffner S. M.,
Balkau B.,
Després J.P.
Publication year - 2013
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12075
Subject(s) - medicine , type 2 diabetes , diabetes mellitus , insulin , endocrinology , abdominal obesity , prospective cohort study , adipose tissue , metabolic syndrome
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 .