Insulin Dose and Cardiovascular Mortality in the ACCORD Trial.

ABSTRACT:

Objective

In the ACCORD trial, intensive treatment of patients with type 2 diabetes and high cardiovascular (CV) risk was associated with higher all-cause and CV mortality. Post hoc analyses have failed to implicate rapid reduction of glucose, hypoglycemia, or specific drugs as the causes of this finding. We hypothesized that exposure to injected insulin was quantitatively associated with increased CV mortality.

Research design and methods

We examined insulin exposure data from 10,163 participants with a mean follow-up of 5 years. Using Cox proportional hazards models, we explored associations between CV mortality and total, basal, and prandial insulin dose over time, adjusting for both baseline and on-treatment covariates including randomized intervention assignment.

Res

SUBMITTER: Siraj ES 

PROVIDER: S-EPMC4876773 | biostudies-literature | 2015 Nov

REPOSITORIES: biostudies-literature