Description
Objectives: To characterize the risk of death according to the achievement of blood glucose, hypertension, and lipid goals in middle-aged and elderly Brazilian adults with type 2 diabetes.
Methods: The Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) is an occupational cohort initiated in 2008 and followed through 2019. We ascertained known diabetes by self-reported diagnosis or anti-diabetic medication use. We measured glycated hemoglobin (HbA1c) and LDL-c centrally. We used 2022 American Diabetes Association treatment targets: HbA1c
Results: After 11 (1.8) years of follow-up, 272 of the 2492 participants with known diabetes had died. Within-target HbA1c was associated with the greatest protection (HR=0.62; 95% IC 0.47-0.81) against all-cause mortality, followed by systolic blood pressure (HR=0.77; 95% IC 0.59-0.99). Achieving these two goals conferred substantial protection (HR=0.39; 95% IC 0.25-0.60). Within-target LDL-c, however, was associated with increased mortality (HR=1.38; 95% IC 1.03-1.84).
Conclusions: Glucose and blood pressure control, especially when concomitant, reduced mortality. The increased mortality associated with achieving the LDL-c target merits further investigation.
Included in
Clinical Epidemiology Commons, Endocrinology, Diabetes, and Metabolism Commons, Epidemiology Commons
Achievement of treatment goals and mortality in individuals with type 2 diabetes: the ELSA-Brasil Study
Objectives: To characterize the risk of death according to the achievement of blood glucose, hypertension, and lipid goals in middle-aged and elderly Brazilian adults with type 2 diabetes.
Methods: The Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) is an occupational cohort initiated in 2008 and followed through 2019. We ascertained known diabetes by self-reported diagnosis or anti-diabetic medication use. We measured glycated hemoglobin (HbA1c) and LDL-c centrally. We used 2022 American Diabetes Association treatment targets: HbA1c
Results: After 11 (1.8) years of follow-up, 272 of the 2492 participants with known diabetes had died. Within-target HbA1c was associated with the greatest protection (HR=0.62; 95% IC 0.47-0.81) against all-cause mortality, followed by systolic blood pressure (HR=0.77; 95% IC 0.59-0.99). Achieving these two goals conferred substantial protection (HR=0.39; 95% IC 0.25-0.60). Within-target LDL-c, however, was associated with increased mortality (HR=1.38; 95% IC 1.03-1.84).
Conclusions: Glucose and blood pressure control, especially when concomitant, reduced mortality. The increased mortality associated with achieving the LDL-c target merits further investigation.
