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Favorable Effects of Insulin Sensitizers Pertinent to Peripheral Arterial Disease in Type 2 Diabetes: Results from the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial

OBJECTIVE: The aim of this manuscript was to report the risk of incident peripheral arterial disease (PAD) in a large randomized clinical trial that enrolled participants with stable coronary artery disease and type 2 diabetes and compare the risk between assigned treatment arms. RESEARCH DESIGN AND...

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Autores principales: Althouse, Andrew D., Abbott, J. Dawn, Sutton-Tyrrell, Kim, Forker, Alan D., Lombardero, Manuel S., Buitrón, L. Virginia, Pena-Sing, Ivan, Tardif, Jean-Claude, Brooks, Maria Mori
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Diabetes Association 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3781574/
https://www.ncbi.nlm.nih.gov/pubmed/23735723
http://dx.doi.org/10.2337/dc12-2265
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author Althouse, Andrew D.
Abbott, J. Dawn
Sutton-Tyrrell, Kim
Forker, Alan D.
Lombardero, Manuel S.
Buitrón, L. Virginia
Pena-Sing, Ivan
Tardif, Jean-Claude
Brooks, Maria Mori
author_facet Althouse, Andrew D.
Abbott, J. Dawn
Sutton-Tyrrell, Kim
Forker, Alan D.
Lombardero, Manuel S.
Buitrón, L. Virginia
Pena-Sing, Ivan
Tardif, Jean-Claude
Brooks, Maria Mori
author_sort Althouse, Andrew D.
collection PubMed
description OBJECTIVE: The aim of this manuscript was to report the risk of incident peripheral arterial disease (PAD) in a large randomized clinical trial that enrolled participants with stable coronary artery disease and type 2 diabetes and compare the risk between assigned treatment arms. RESEARCH DESIGN AND METHODS: The Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial randomly assigned participants to insulin sensitization (IS) therapy versus insulin-providing (IP) therapy for glycemic control. Results showed similar 5-year mortality in the two glycemic treatment arms. In secondary analyses reported here, we examine the effects of treatment assignment on the incidence of PAD. A total of 1,479 BARI 2D participants with normal ankle-brachial index (ABI) (0.91–1.30) were eligible for analysis. The following PAD-related outcomes are evaluated in this article: new low ABI ≤0.9, a lower-extremity revascularization, lower-extremity amputation, and a composite of the three outcomes. RESULTS: During an average 4.6 years of follow-up, 303 participants experienced one or more of the outcomes listed above. Incidence of the composite outcome was significantly lower among participants assigned to IS therapy than those assigned to IP therapy (16.9 vs. 24.1%; P < 0.001). The difference was significant in time-to-event analysis (hazard ratio 0.66 [95% CI 0.51–0.83], P < 0.001) and remained significant after adjustment for in-trial HbA(1c) (0.76 [0.59–0.96], P = 0.02). CONCLUSIONS: In participants with type 2 diabetes who are free from PAD, a glycemic control strategy of insulin sensitization may be the preferred therapeutic strategy to reduce the incidence of PAD and subsequent outcomes.
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spelling pubmed-37815742014-10-01 Favorable Effects of Insulin Sensitizers Pertinent to Peripheral Arterial Disease in Type 2 Diabetes: Results from the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial Althouse, Andrew D. Abbott, J. Dawn Sutton-Tyrrell, Kim Forker, Alan D. Lombardero, Manuel S. Buitrón, L. Virginia Pena-Sing, Ivan Tardif, Jean-Claude Brooks, Maria Mori Diabetes Care Original Research OBJECTIVE: The aim of this manuscript was to report the risk of incident peripheral arterial disease (PAD) in a large randomized clinical trial that enrolled participants with stable coronary artery disease and type 2 diabetes and compare the risk between assigned treatment arms. RESEARCH DESIGN AND METHODS: The Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial randomly assigned participants to insulin sensitization (IS) therapy versus insulin-providing (IP) therapy for glycemic control. Results showed similar 5-year mortality in the two glycemic treatment arms. In secondary analyses reported here, we examine the effects of treatment assignment on the incidence of PAD. A total of 1,479 BARI 2D participants with normal ankle-brachial index (ABI) (0.91–1.30) were eligible for analysis. The following PAD-related outcomes are evaluated in this article: new low ABI ≤0.9, a lower-extremity revascularization, lower-extremity amputation, and a composite of the three outcomes. RESULTS: During an average 4.6 years of follow-up, 303 participants experienced one or more of the outcomes listed above. Incidence of the composite outcome was significantly lower among participants assigned to IS therapy than those assigned to IP therapy (16.9 vs. 24.1%; P < 0.001). The difference was significant in time-to-event analysis (hazard ratio 0.66 [95% CI 0.51–0.83], P < 0.001) and remained significant after adjustment for in-trial HbA(1c) (0.76 [0.59–0.96], P = 0.02). CONCLUSIONS: In participants with type 2 diabetes who are free from PAD, a glycemic control strategy of insulin sensitization may be the preferred therapeutic strategy to reduce the incidence of PAD and subsequent outcomes. American Diabetes Association 2013-10 2013-09-14 /pmc/articles/PMC3781574/ /pubmed/23735723 http://dx.doi.org/10.2337/dc12-2265 Text en © 2013 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Original Research
Althouse, Andrew D.
Abbott, J. Dawn
Sutton-Tyrrell, Kim
Forker, Alan D.
Lombardero, Manuel S.
Buitrón, L. Virginia
Pena-Sing, Ivan
Tardif, Jean-Claude
Brooks, Maria Mori
Favorable Effects of Insulin Sensitizers Pertinent to Peripheral Arterial Disease in Type 2 Diabetes: Results from the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial
title Favorable Effects of Insulin Sensitizers Pertinent to Peripheral Arterial Disease in Type 2 Diabetes: Results from the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial
title_full Favorable Effects of Insulin Sensitizers Pertinent to Peripheral Arterial Disease in Type 2 Diabetes: Results from the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial
title_fullStr Favorable Effects of Insulin Sensitizers Pertinent to Peripheral Arterial Disease in Type 2 Diabetes: Results from the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial
title_full_unstemmed Favorable Effects of Insulin Sensitizers Pertinent to Peripheral Arterial Disease in Type 2 Diabetes: Results from the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial
title_short Favorable Effects of Insulin Sensitizers Pertinent to Peripheral Arterial Disease in Type 2 Diabetes: Results from the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial
title_sort favorable effects of insulin sensitizers pertinent to peripheral arterial disease in type 2 diabetes: results from the bypass angioplasty revascularization investigation 2 diabetes (bari 2d) trial
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3781574/
https://www.ncbi.nlm.nih.gov/pubmed/23735723
http://dx.doi.org/10.2337/dc12-2265
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