A newly developed frailty index (FI) for sufferers with sort 2 diabetes (T2D) recognized people at excessive threat for poorer outcomes. These findings have been printed in Diabetes Care.
Information from the Motion in Diabetes and Vascular Illness: Preterax and Diamicron Modified Launch Managed Analysis (ADVANCE) trial have been analyzed on this secondary submit hoc research by researchers in Australia and elsewhere around the globe. The frailty index comprised 34 age-related well being variables valued from 0 to 1. The frailty index was retrospectively calculated, and threat for mortality and macrovascular and microvascular occasions was assessed.
ADVANCE individuals (N=11,140) had a imply age of 65.8 years at baseline and 42.5% have been ladies. The frailty index was usually distributed, starting from 0 to 0.53 (imply, 0.17; SD, 0.08).
A cutoff level for frailty was decided to be 0.21, indicating 25.7% of the inhabitants was frail. There was an age interplay, wherein extra sufferers who have been 65 years and older have been frail (hazard ratio [HR], 2.16; 95% CI, 1.93-2.41) in contrast with these youthful than 65 years (HR, 1.61; 95% CI, 1.39-1.87; P =.01).
Sufferers who have been frail at baseline had elevated charges of cardiovascular mortality (adjusted HR [aHR], 3.01; 95% CI, 2.55-3.57), main macrovascular occasions (aHR, 2.31; 95% CI, 2.05-2.59), all-cause mortality (aHR, 2.18; 95% CI, 1.93-2.47), main microvascular occasions (aHR, 1.60; 95% CI, 1.42-1.81), and extreme hypoglycemic occasions (aHR, 1.57; 95% CI, 1.20-2.06).
The blood stress (BP)-lowering intervention decreased threat for mixed macrovascular and microvascular occasions amongst nonfrail (HR, 0.86; 95% CI, 0.77-0.97) and frail (HR, 0.97; 95% CI, 0.83-1.13) sufferers. Decreased all-cause mortality amongst nonfrail (HR, 0.79; 95% CI, 0.66-0.94) and frail (HR, 0.95; 95% CI, 0.78-1.16) teams was additionally noticed.
Intensive glucose management interventions decreased the danger for mixed macrovascular and microvascular occasions amongst nonfrail (HR, 0.84; 95% CI, 0.75-0.94) and frail (HR, 1.03; 95% CI, 0.90-1.18) sufferers. Decreased all-cause mortality among the many nonfrail (HR, 0.83; 95% CI, 0.71-0.98) and frail (HR, 1.11; 95% CI, 0.92-1.34) cohorts was additionally noticed.
This research was restricted by the variety of variables collected that could possibly be integrated into the frailty index calculation.
The research authors concluded the frailty index recognized people at increased threat for poorer medical outcomes and that BP-lowering and intensive glucose management interventions had some impact at mitigating poor outcomes.
Disclosure: Some authors declared affiliations with biotech, pharmaceutical, and/or system producers. Please see the unique reference for a full checklist of authors’ disclosures.
Nguyen TN, Harris Ok, Woodward M, et al. The impact of frailty on the effectiveness and safety of intensive glucose control and blood pressure-lowering therapy for people with type 2 diabetes: results from the ADVANCE Trial. Diabetes Care. Printed on-line Might 25, 2021. doi:10.2337/dc20-2664