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@article{1158990,
author = {Shen, L. and Shah, B.R. and Reyes, E.M. and Thomas, L. and Wojdyla, D. and Diem, P. and Leiter, L.A. and Charbonnel, B. and Mareev, V. and Horton, E.S. and Hafner, S.M. and Soška, Vladimír and Holman, R. and Bethel, M.A. and Schaper, F. and Sun, J.L. and McMurray, J.J. and Califf, R.M. and Krum, H.},
article_location = {London},
article_number = {f6745},
doi = {http://dx.doi.org/10.1136/bmj.f6745},
keywords = {diuretic; beta-blocker; statin; diabetes},
language = {eng},
issn = {1756-1833},
journal = {BMJ-BRITISH MEDICAL JOURNAL},
title = {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.},
volume = {347},
year = {2013}
}
TY - JOUR
ID - 1158990
AU - Shen, L. - Shah, B.R. - Reyes, E.M. - Thomas, L. - Wojdyla, D. - Diem, P. - Leiter, L.A. - Charbonnel, B. - Mareev, V. - Horton, E.S. - Hafner, S.M. - Soška, Vladimír - Holman, R. - Bethel, M.A. - Schaper, F. - Sun, J.L. - McMurray, J.J. - Califf, R.M. - Krum, H.
PY - 2013
TI - 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.
JF - BMJ-BRITISH MEDICAL JOURNAL
VL - 347
IS - f6745
SP - 1-11
EP - 1-11
PB - BMJ PUBLISHING GROUP
SN - 17561833
KW - diuretic
KW - beta-blocker
KW - statin
KW - diabetes
N2 - 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.
ER -
SHEN, L., B.R. SHAH, E.M. REYES, L. THOMAS, D. WOJDYLA, P. DIEM, L.A. LEITER, B. CHARBONNEL, V. MAREEV, E.S. HORTON, S.M. HAFNER, Vladimír SOŠKA, R. HOLMAN, M.A. BETHEL, F. SCHAPER, J.L. SUN, J.J. MCMURRAY, R.M. CALIFF and H. KRUM. 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. (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). \textit{BMJ-BRITISH MEDICAL JOURNAL}. London: BMJ PUBLISHING GROUP, 2013, vol.~347, f6745, p.~1-11. ISSN~1756-1833. Available from: https://dx.doi.org/10.1136/bmj.f6745.
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