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Impact of insulin therapy on outcomes of diabetic patients with heart failure: A systematic review and meta-analysis

OBJECTIVE: To compare clinical outcomes in diabetic patients with heart failure managed by insulin with those managed by non-insulin (oral hypoglycemic agents and/or lifestyle modification) based therapy. METHODS: PubMed and Scopus databases were searched for studies conducted on diabetic patients w...

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Autores principales: Liu, Jingxing, Hu, Xinhua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9102182/
https://www.ncbi.nlm.nih.gov/pubmed/35543342
http://dx.doi.org/10.1177/14791641221093175
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author Liu, Jingxing
Hu, Xinhua
author_facet Liu, Jingxing
Hu, Xinhua
author_sort Liu, Jingxing
collection PubMed
description OBJECTIVE: To compare clinical outcomes in diabetic patients with heart failure managed by insulin with those managed by non-insulin (oral hypoglycemic agents and/or lifestyle modification) based therapy. METHODS: PubMed and Scopus databases were searched for studies conducted on diabetic patients with heart failure. Studies were to compare outcomes of patients managed by insulin versus non-insulin therapies. RESULTS: 15 studies were included. Compared to those who were managed using non-insulin therapy, insulin-treated patients had increased risk of all-cause mortality (RR 1.46, 95% CI: 1.14, 1.88) and cardiovascular specific mortality (RR 1.62, 95% CI: 1.33, 1.96). Those managed using insulin also had increased risk of hospitalization (RR 1.45, 95% CI: 1.09, 1.93) and readmission (RR 1.49, 95% CI: 1.32, 1.67). There was no additional risk for stroke (RR 1.07, 95% CI: 0.91, 1.27) or myocardial infarction (MI) (RR 1.10, 95% CI: 0.96, 1.27) between the two groups of patients. CONCLUSIONS: Receipt of insulin among diabetic patients with heart failure was associated with an increased risk of mortality, hospitalization and readmission compared to management using oral hypoglycemic agents and/or lifestyle modification. Such patients should be closely monitored for any adverse events.
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spelling pubmed-91021822022-05-14 Impact of insulin therapy on outcomes of diabetic patients with heart failure: A systematic review and meta-analysis Liu, Jingxing Hu, Xinhua Diab Vasc Dis Res Review Article OBJECTIVE: To compare clinical outcomes in diabetic patients with heart failure managed by insulin with those managed by non-insulin (oral hypoglycemic agents and/or lifestyle modification) based therapy. METHODS: PubMed and Scopus databases were searched for studies conducted on diabetic patients with heart failure. Studies were to compare outcomes of patients managed by insulin versus non-insulin therapies. RESULTS: 15 studies were included. Compared to those who were managed using non-insulin therapy, insulin-treated patients had increased risk of all-cause mortality (RR 1.46, 95% CI: 1.14, 1.88) and cardiovascular specific mortality (RR 1.62, 95% CI: 1.33, 1.96). Those managed using insulin also had increased risk of hospitalization (RR 1.45, 95% CI: 1.09, 1.93) and readmission (RR 1.49, 95% CI: 1.32, 1.67). There was no additional risk for stroke (RR 1.07, 95% CI: 0.91, 1.27) or myocardial infarction (MI) (RR 1.10, 95% CI: 0.96, 1.27) between the two groups of patients. CONCLUSIONS: Receipt of insulin among diabetic patients with heart failure was associated with an increased risk of mortality, hospitalization and readmission compared to management using oral hypoglycemic agents and/or lifestyle modification. Such patients should be closely monitored for any adverse events. SAGE Publications 2022-05-11 /pmc/articles/PMC9102182/ /pubmed/35543342 http://dx.doi.org/10.1177/14791641221093175 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review Article
Liu, Jingxing
Hu, Xinhua
Impact of insulin therapy on outcomes of diabetic patients with heart failure: A systematic review and meta-analysis
title Impact of insulin therapy on outcomes of diabetic patients with heart failure: A systematic review and meta-analysis
title_full Impact of insulin therapy on outcomes of diabetic patients with heart failure: A systematic review and meta-analysis
title_fullStr Impact of insulin therapy on outcomes of diabetic patients with heart failure: A systematic review and meta-analysis
title_full_unstemmed Impact of insulin therapy on outcomes of diabetic patients with heart failure: A systematic review and meta-analysis
title_short Impact of insulin therapy on outcomes of diabetic patients with heart failure: A systematic review and meta-analysis
title_sort impact of insulin therapy on outcomes of diabetic patients with heart failure: a systematic review and meta-analysis
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9102182/
https://www.ncbi.nlm.nih.gov/pubmed/35543342
http://dx.doi.org/10.1177/14791641221093175
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