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Medication profiling in women with type 1 diabetes highlights the importance of adequate, guideline-based treatment in low-risk groups
Effective treatment may prevent kidney complications, but women might be underprescribed. Novel, data-driven insights into prescriptions and their relationship with kidney health in women with type 1 diabetes may help to optimize treatment. We identified six medication profiles in 1164 women from th...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10587128/ https://www.ncbi.nlm.nih.gov/pubmed/37857707 http://dx.doi.org/10.1038/s41598-023-44695-2 |
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author | Lithovius, Raija Mutter, Stefan Parente, Erika B. Mäkinen, Ville-Petteri Valo, Erkka Harjutsalo, Valma Groop, Per-Henrik |
author_facet | Lithovius, Raija Mutter, Stefan Parente, Erika B. Mäkinen, Ville-Petteri Valo, Erkka Harjutsalo, Valma Groop, Per-Henrik |
author_sort | Lithovius, Raija |
collection | PubMed |
description | Effective treatment may prevent kidney complications, but women might be underprescribed. Novel, data-driven insights into prescriptions and their relationship with kidney health in women with type 1 diabetes may help to optimize treatment. We identified six medication profiles in 1164 women from the FinnDiane Study with normal albumin excretion rate based on clusters of their baseline prescription data using a self-organizing map. Future rapid kidney function decline was defined as an annual estimated glomerular filtration rate (eGFR) loss > 3 ml/min/1.73 m(2) after baseline. Two profiles were associated with future decline: Profile ARB with the highest proportion of angiotensin receptor blockers (odds ratio [OR] 2.75, P = 0.02) and highly medicated women in profile HighMed (OR 2.55, P = 0.03). Compared with profile LowMed (low purchases of all), profile HighMed had worse clinical characteristics, whereas in profile ARB only systolic blood pressure was elevated. Importantly, the younger women in profile ARB with fewer kidney protective treatments developed a rapid decline despite otherwise similar baseline characteristics to profile ACE & Lipids (the highest proportions of ACE inhibitors and lipid-modifying agents) without a future rapid decline. In conclusion, medication profiles identified different future eGFR trajectories in women with type 1 diabetes revealing potential treatment gaps for younger women. |
format | Online Article Text |
id | pubmed-10587128 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-105871282023-10-21 Medication profiling in women with type 1 diabetes highlights the importance of adequate, guideline-based treatment in low-risk groups Lithovius, Raija Mutter, Stefan Parente, Erika B. Mäkinen, Ville-Petteri Valo, Erkka Harjutsalo, Valma Groop, Per-Henrik Sci Rep Article Effective treatment may prevent kidney complications, but women might be underprescribed. Novel, data-driven insights into prescriptions and their relationship with kidney health in women with type 1 diabetes may help to optimize treatment. We identified six medication profiles in 1164 women from the FinnDiane Study with normal albumin excretion rate based on clusters of their baseline prescription data using a self-organizing map. Future rapid kidney function decline was defined as an annual estimated glomerular filtration rate (eGFR) loss > 3 ml/min/1.73 m(2) after baseline. Two profiles were associated with future decline: Profile ARB with the highest proportion of angiotensin receptor blockers (odds ratio [OR] 2.75, P = 0.02) and highly medicated women in profile HighMed (OR 2.55, P = 0.03). Compared with profile LowMed (low purchases of all), profile HighMed had worse clinical characteristics, whereas in profile ARB only systolic blood pressure was elevated. Importantly, the younger women in profile ARB with fewer kidney protective treatments developed a rapid decline despite otherwise similar baseline characteristics to profile ACE & Lipids (the highest proportions of ACE inhibitors and lipid-modifying agents) without a future rapid decline. In conclusion, medication profiles identified different future eGFR trajectories in women with type 1 diabetes revealing potential treatment gaps for younger women. Nature Publishing Group UK 2023-10-19 /pmc/articles/PMC10587128/ /pubmed/37857707 http://dx.doi.org/10.1038/s41598-023-44695-2 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Lithovius, Raija Mutter, Stefan Parente, Erika B. Mäkinen, Ville-Petteri Valo, Erkka Harjutsalo, Valma Groop, Per-Henrik Medication profiling in women with type 1 diabetes highlights the importance of adequate, guideline-based treatment in low-risk groups |
title | Medication profiling in women with type 1 diabetes highlights the importance of adequate, guideline-based treatment in low-risk groups |
title_full | Medication profiling in women with type 1 diabetes highlights the importance of adequate, guideline-based treatment in low-risk groups |
title_fullStr | Medication profiling in women with type 1 diabetes highlights the importance of adequate, guideline-based treatment in low-risk groups |
title_full_unstemmed | Medication profiling in women with type 1 diabetes highlights the importance of adequate, guideline-based treatment in low-risk groups |
title_short | Medication profiling in women with type 1 diabetes highlights the importance of adequate, guideline-based treatment in low-risk groups |
title_sort | medication profiling in women with type 1 diabetes highlights the importance of adequate, guideline-based treatment in low-risk groups |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10587128/ https://www.ncbi.nlm.nih.gov/pubmed/37857707 http://dx.doi.org/10.1038/s41598-023-44695-2 |
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