ArticleDiabetologia2015
Glucose, blood pressure and cholesterol levels and their relationships to clinical outcomes in type 2 diabetes: a retrospective cohort study.
Article in Diabetologia, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 46 papers, 3 of them syntheses that pooled it.
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Who cites it
46 citing papers in PubMed, 3 syntheses or guidelines pooled it, 75 citations in OpenAlex.
- Adherence to and persistence with antidiabetic medications and associations with clinical and economic outcomes in people with type 2 diabetes mellitus: A systematic literature review.Diabetes, obesity & metabolism · 2022Pooled it
- The Effectiveness of Pharmacological and Non-Pharmacological Interventions for Improving Glycaemic Control in Adults with Severe Mental Illness: A Systematic Review and Meta-Analysis.PloS one · 2017 · on this mapPooled it
- The Association between Sulfonylurea Use and All-Cause and Cardiovascular Mortality: A Meta-Analysis with Trial Sequential Analysis of Randomized Clinical Trials.PLoS medicine · 2016Pooled it
- Diabetic Complication Profiles and Associated Risk Factors: A Comprehensive Analysis from Two Public Hospitals in the Najran Region, Southern Saudi Arabia.Medicina (Kaunas, Lithuania) · 2025Article
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- 3D facial imaging: a novel approach for metabolic abnormalities risk profiling.Science China. Life sciences · 2025Article
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- Adherence and Persistence to Basal Insulin Among People with Type 2 Diabetes in Europe: A Systematic Literature Review and Meta-analysis.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2024Review
- Neutrophil Lymphocyte Ratio as a Predictor of Stroke Severity in Type 2 Diabetes Mellitus: A Single-Center Study.Cureus · 2024Article
- Association Between the Hepatic Steatosis Index and Risk of Incident Type 2 Diabetes Mellitus in the Normoglycemic Population:A Longitudinal Prospective Study in Japan.Diabetes, metabolic syndrome and obesity : targets and therapy · 2024Article
- Improving health outcomes of people with diabetes: target setting for the WHO Global Diabetes Compact.Lancet (London, England) · 2023Article
- Effectiveness of Continuous Glucose Monitoring in Older Adults with Type 2 Diabetes Treated with Basal Insulin.Diabetes technology & therapeutics · 2022Article
- Prediction of Five-Year Cardiovascular Disease Risk in People with Type 2 Diabetes Mellitus: Derivation in Nanjing, China and External Validation in Scotland, UK.Global heart · 2022Article
- Association Between Cardiovascular Disease Risk Factors and Mortality in Adults With Diabetes: A Stratified Analysis by Sex, Race, and Ethnicity.International journal of public health · 2022Article
- Association between blood pressure and the risk of chronic kidney disease in treatment-naïve hypertensive patients.Kidney research and clinical practice · 2022Article
- Health of mothers of children with a life-limiting condition: a comparative cohort study.Archives of disease in childhood · 2021Observational
- Predictive scores for identifying patients with type 2 diabetes mellitus at risk of acute myocardial infarction and sudden cardiac death.Endocrinology, diabetes & metabolism · 2021Article
- Associations between attainment of incentivised primary care indicators and emergency hospital admissions among type 2 diabetes patients: a population-based historical cohort study.Journal of the Royal Society of Medicine · 2021Article
- Associations between attainment of incentivized primary care indicators and incident sight-threatening diabetic retinopathy in England: A population-based historical cohort study.Diabetes, obesity & metabolism · 2021Article
- Associations between attainment of incentivized primary care indicators and incident lower limb amputation among those with type 2 diabetes: a population-based historical cohort study.BMJ open diabetes research & care · 2021Article
Corrections and comments
- Erratum issuedErratum to: Glucose, blood pressure and cholesterol levels and their relationships to clinical outcomes in type 2 diabetes: a retrospective cohort study.2015 · Rutter, Martin [corrected to Rutter, Martin K]
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
aims/hypothesisWe aimed to describe the shape of observed relationships between risk factor levels and clinically important outcomes in type 2 diabetes after adjusting for multiple confounders.
methodsWe used retrospective longitudinal data on 246,544 adults with type 2 diabetes from 600 practices in the Clinical Practice Research Datalink, 2006-2012. Proportional hazards regression models quantified the risks of mortality and microvascular or macrovascular events associated with four modifiable biological variables (HbA1c, systolic BP, diastolic BP and total cholesterol), while controlling for important patient and practice covariates.
resultsU-shaped relationships were observed between all-cause mortality and levels of the four biometric risk factors. Lowest risks were associated with HbA1c 7.25-7.75% (56-61 mmol/mol), total cholesterol 3.5-4.5 mmol/l, systolic BP 135-145 mmHg and diastolic BP 82.5-87.5 mmHg. Coronary and stroke mortality related to the four risk factors in a positive, curvilinear way, with the exception of systolic BP, which related to deaths in a U-shape. Macrovascular events showed a positive and curvilinear relationship with HbA1c but a U-shaped relationship with total cholesterol and systolic BP. Microvascular events related to the four risk factors in a curvilinear way: positive for HbA1c and systolic BP but negative for cholesterol and diastolic BP. CONCLUSIONS/
interpretationWe identified several relationships that support a call for major changes to clinical practice. Most importantly, our results support trial data indicating that normalisation of glucose and BP can lead to poorer outcomes. This makes a strong case for target ranges for these risk factors rather than target levels.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.