Evidence map›Paper›PMID 26809442›Full record

ArticleCardiovascular diabetology2016

Cardiovascular disease guideline adherence and self-reported statin use in longstanding type 1 diabetes: results from the Canadian study of longevity in diabetes cohort.

Johnny W Bai, Geneviève Boulet, Elise M Halpern, Leif E Lovblom, Devrim Eldelekli, Hillary A Keenan, Michael Brent, Narinder Paul, Vera Bril, David Z I Cherney and 2 more

Full text readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Cardiovascular diabetology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed.

  1. Observational
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  8. Review
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  14. Observational
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  19. Diabetic Retinopathy and Dementia in Type 1 Diabetes.Alzheimer disease and associated disorders
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Johnny W BaiDivision of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, L5-210, 60 Murray Street, Mail Box 16, Toronto, ON, M5T 3L9, Canada. jw.bai@mail.utoronto.ca.
Geneviève BouletDivision of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, L5-210, 60 Murray Street, Mail Box 16, Toronto, ON, M5T 3L9, Canada. boulet@lunenfeld.ca.
Elise M HalpernDivision of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, L5-210, 60 Murray Street, Mail Box 16, Toronto, ON, M5T 3L9, Canada. elise.halpern@gmail.com.
Leif E LovblomDivision of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, L5-210, 60 Murray Street, Mail Box 16, Toronto, ON, M5T 3L9, Canada. lovblom@lunenfeld.ca.
Devrim EldelekliDivision of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, L5-210, 60 Murray Street, Mail Box 16, Toronto, ON, M5T 3L9, Canada. eldelekli@lunenfeld.ca.
Hillary A KeenanResearch Division, Joslin Diabetes Center, Boston, MA, USA. hillary.keenan@joslin.harvard.edu.
Michael BrentDepartment of Ophthalmology and Vision Sciences, Department of Medicine, University of Toronto, Toronto, ON, Canada. michael.brent@uhn.ca.
Narinder PaulJoint Department of Medical Imaging, Division of Cardiothoracic Radiology, University Health Network, Toronto, ON, Canada. narinder.paul@uhn.ca.
Vera BrilThe Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Krembil Neuroscience Centre, Division of Neurology, Department of Medicine, University Health Network, University of Toronto, Toronto, ON, Canada. vera.bril@utoronto.ca.
David Z I CherneyDivision of Nephrology, Department of Medicine, University of Toronto, Toronto, ON, Canada. david.cherney@uhn.ca.
Alanna WeismanDivision of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, L5-210, 60 Murray Street, Mail Box 16, Toronto, ON, M5T 3L9, Canada. alanna.weisman@mail.utoronto.ca.
Bruce A PerkinsDivision of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, L5-210, 60 Murray Street, Mail Box 16, Toronto, ON, M5T 3L9, Canada. BPerkins@mtsinai.on.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOlder patients with longstanding type 1 diabetes have high cardiovascular disease (CVD) risk such that statin therapy is recommended independent of prior CVD events. We aimed to determine self-reported CVD prevention guideline adherence in patients with longstanding diabetes. RESEARCH DESIGN AND

methods309 Canadians with over 50 years of type 1 diabetes completed a medical questionnaire for presence of lifestyle and pharmacological interventions, stratified into primary or secondary CVD prevention subgroups based on absence or presence of self-reported CVD events, respectively. Associations with statin use were analyzed using multivariable logistic regression.

resultsThe 309 participants had mean ± SD age 65.7 ± 8.5 years, median diabetes duration 54.0 [IQR 51.0, 59.0] years, and HbA1c of 7.5 ± 1.1 % (58 mmol/mol). 159 (52.7 %) participants reported diet adherence, 296 (95.8 %) smoking avoidance, 217 (70.5 %) physical activity, 218 (71.5 %) renin-angiotensin-system inhibitor use, and 220 (72.1 %) statin use. Physical activity was reported as less common in the secondary prevention subgroup, and current statin use was significantly lower in the primary prevention subgroup (65.5 % vs. 84.8 %, p = 0.0004). In multivariable logistic regression, the odds of statin use was 0.38 [95 % CI 0.15-0.95] in members of the primary compared to the secondary prevention subgroup, adjusting for age, sex, hypertension history, body mass, HbA1c, cholesterol, microvascular complications, acetylsalicylic acid use, and renin-angiotensin system inhibitor use.

conclusionDespite good self-reported adherence to general CVD prevention guidelines, against the principles of these guidelines we found that statin use was substantially lower in those without CVD history. Interventions are needed to improve statin use in older type 1 diabetes patients without a history of CVD.

Indexed as

Guideline AdherenceLongevityMedication AdherenceRisk Reduction BehaviorAgedAngiotensin-Converting Enzyme InhibitorsAngiotensin II Type 1 Receptor BlockersCanadaCardiovascular DiseasesChi-Square DistributionCross-Sectional StudiesDiabetes Mellitus, Type 1DietDyslipidemiasExerciseFemaleAngiotensin-Converting Enzyme InhibitorsAngiotensin II Type 1 Receptor BlockersHydroxymethylglutaryl-CoA Reductase Inhibitors

Identifiers

PMID26809442
PMCPMC4727297

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Registered trials

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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.