J 2013

Role of diuretics, beta blockers, and statins in increasing the risk of diabetes in patients with impaired glucose tolerance: reanalysis of data from the NAVIGATOR study.

SHEN, L., B.R. SHAH, E.M. REYES, L. THOMAS, D. WOJDYLA et. al.

Basic information

Original name

Role of diuretics, beta blockers, and statins in increasing the risk of diabetes in patients with impaired glucose tolerance: reanalysis of data from the NAVIGATOR study.

Authors

SHEN, L. (156 China), B.R. SHAH (840 United States of America), E.M. REYES (840 United States of America), L. THOMAS (840 United States of America), D. WOJDYLA (840 United States of America), P. DIEM (756 Switzerland), L.A. LEITER (124 Canada), B. CHARBONNEL (250 France), V. MAREEV (643 Russian Federation), E.S. HORTON (840 United States of America), S.M. HAFNER (826 United Kingdom of Great Britain and Northern Ireland), Vladimír SOŠKA (203 Czech Republic, guarantor, belonging to the institution), R. HOLMAN (826 United Kingdom of Great Britain and Northern Ireland), M.A. BETHEL (826 United Kingdom of Great Britain and Northern Ireland), F. SCHAPER (276 Germany), J.L. SUN (840 United States of America), J.J. MCMURRAY (826 United Kingdom of Great Britain and Northern Ireland), R.M. CALIFF (840 United States of America) and H. KRUM (36 Australia)

Edition

BMJ-BRITISH MEDICAL JOURNAL, London, BMJ PUBLISHING GROUP, 2013, 1756-1833

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 16.378

RIV identification code

RIV/00216224:14110/13:00070953

Organization unit

Faculty of Medicine

DOI

UT WoS

000328574400002

Keywords in English

diuretic; beta-blocker; statin; diabetes

Tags

International impact, Reviewed
Změněno: 30/1/2014 16:55, Soňa Böhmová

Abstract

V originále

Objective To examine the degree to which use of beta blockers, statins, and diuretics in patients with impaired glucose tolerance and other cardiovascular risk factors is associated with new onset diabetes. Design Reanalysis of data from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial. Setting NAVIGATOR trial. Participants Patients who at baseline (enrolment) were treatment naive to beta blockers (n=5640), diuretics (n=6346), statins (n=6146), and calcium channel blockers (n=6294). Use of calcium channel blocker was used as a metabolically neutral control. Main outcome measures Development of new onset diabetes diagnosed by standard plasma glucose level in all participants and confirmed with glucose tolerance testing within 12 weeks after the increased glucose value was recorded. The relation between each treatment and new onset diabetes was evaluated using marginal structural models for causal inference, to account for time dependent confounding in treatment assignment. Results During the median five years of follow-up, beta blockers were started in 915 (16.2%) patients, diuretics in 1316 (20.7%), statins in 1353 (22.0%), and calcium channel blockers in 1171 (18.6%). After adjusting for baseline characteristics and time varying confounders, diuretics and statins were both associated with an increased risk of new onset diabetes (hazard ratio 1.23, 95% confidence interval 1.06 to 1.44, and 1.32, 1.14 to 1.48, respectively), whereas beta blockers and calcium channel blockers were not associated with new onset diabetes (1.10, 0.92 to 1.31, and 0.95, 0.79 to 1.13, respectively). Conclusions Among people with impaired glucose tolerance and other cardiovascular risk factors and with serial glucose measurements, diuretics and statins were associated with an increased risk of new onset diabetes, whereas the effect of beta blockers was non-significant.