Dataset Information

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

ABSTRACT:

Objective

To examine the degree to which use of β 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 naïve to β 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, β 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 β 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 β blockers was non-significant.

Trial registration

ClinicalTrials.gov NCT00097786.

SUBMITTER: Shen L

PROVIDER: S-EPMC3898638 | biostudies-literature | 2013 Dec

REPOSITORIES: biostudies-literature

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Publications

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

Shen Lan L Shah Bimal R BR Reyes Eric M EM Thomas Laine L Wojdyla Daniel D Diem Peter P Leiter Lawrence A LA Charbonnel Bernard B Mareev Viacheslav V Horton Edward S ES Haffner Steven M SM Soska Vladimir V Holman Rury R Bethel M Angelyn MA Schaper Frank F Sun Jie-Lena JL McMurray John J V JJ Califf Robert M RM Krum Henry H

BMJ (Clinical research ed.) 20131209

<h4>Objective</h4>To examine the degree to which use of β blockers, statins, and diuretics in patients with impaired glucose tolerance and other cardiovascular risk factors is associated with new onset diabetes.<h4>Design</h4>Reanalysis of data from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) trial.<h4>Setting</h4>NAVIGATOR trial.<h4>Participants</h4>Patients who at baseline (enrolment) were treatment naïve to β blockers (n=5640), diuretics (n=6346), ...[more]

PMID: 24322398

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Dataset Information

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

Objective

Design

Setting

Participants

Main outcome measures

Results

Conclusions

Trial registration

Publications

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

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