Oliver Kuss1,2,3 · Michael Roden3,4,5 · Sabrina Schlesinger1,3 · Annika Hoyer6
Received: 27 May 2024 / Accepted: 23 November 2024 / Published online: 12 December 2024 © The Author(s) 2024
Abstract
Aims Two prerequisites must be met for the precision treatment approach to be beneficial for treated individuals. First, there must be treatment heterogeneity; second, in case of treatment heterogeneity, clinical predictors to identify people who would benefit from one treatment more than from others must be available. There is an established meta-regression approach to assess these two prerequisites that relies on measuring the variability of a clinical outcome after treatment in placebo-controlled randomised trials. We recently applied this approach to the treatment of type 2 diabetes for the clinical outcomes of glycaemic control and body weight and repeat it for the clinical outcome of all-cause mortality.
Methods We performed a meta-regression analysis using digitalized individual participant information on time to death from 10 large cardiovascular outcome trials (7563 deaths from 99,746 participants) on DPP-4 inhibitors, GLP-1 receptor agonists, and SGLT-2 inhibitors with respect to the variability of all-cause mortality and its potential predictors after treatment.
Results The adjusted difference in log(SD) values of time to death between the verum and placebo arms was −0.036 (95%- CI: −0.059; −0.013), showing larger variability of time to death in the placebo arms. No clinical predictors were found to explain treatment heterogeneity.
Conclusions This analysis suggests that the potential of the precision treatment approach in type 2 diabetes is low, at least with regard to improvement of all-cause mortality in population with high cardiovascular risk. This extends our previous findings for the clinical outcomes of glycaemic control and body weight.
Keywords Dipeptidyl peptidase-4 inhibitors · Glucagon-like peptide 1 · HbA1c · Meta-regression · Precision medicine · Sodium–glucose transporter 2 inhibitors · Type 2 diabetes mellitus
Annunziata Lapolla1 · Maria Grazia Dalfrà1 · Giuseppe Marelli2 · Mario Parrillo3 · Laura Sciacca4 · Maria Angela Sculli5 · Elena Succurro6 · Elisabetta Torlone7 · Ester Vitacolonna8
Received: 18 September 2024 / Accepted: 27 December 2024 / Published online: 22 January 2025 © Springer-Verlag Italia S.r.l., part of Springer Nature 2025
Proper nutrition is essential during pregnancy to ensure an adequate supply of nutrients to the foetus and adequate maternal weight gain. In pregnancy complicated by diabetes (both gestational and pre-gestational), diet in terms of both the intake and quality of carbohydrates is an essential factor in glycaemic control. Maternal BMI at conception defines the correct weight increase during gestation in order to reduce maternal-foetal complications related to hypo- or hyper-nutrition. The recommendations presented here, which are based on national and international guidelines and the most recently published data on nutrition in physiological pregnancy and pregnancy complicated by hyperglycaemia and/or obesity, are designed to help healthcare professionals prescribe suitable eating patterns to safeguard the health of the mother and the foetus.
原创:伤口治疗及造口护理中心
接着我们上一次内容,如果压力性损伤一旦发生,我们的家庭护理重点将从预防转成减缓其发展和促进愈合。那么愈合减缓压力性损伤的发展内?
四月已接近尾声,五月已悄悄来临,对于每一位护士来说,五月是不平凡的一月。5.12护士节马上就要来临了,小编作为临床护理工作岗位上的普通一员,心里也是异常激动,无论是院里还是市里都筹备着丰富多彩的节目和各项比赛。应领导号召,小编自己也积极参加各项活动。但无奈分身乏术。在此向大家致歉,没有及时更新内容。让各位读者久等了。再次向大家致歉。今天小编就向大家继续讲解关于压力性损伤的相关内容。
人的一生中,从生命开始到生命结束,是一个不断变化的过程。
原创: 张欣 王巍 京医通
糖尿病足是糖尿病最常见的并发症之一,糖尿病患者一生中患足溃疡的风险为10%至25%。糖尿病足感染容易扩散,尤其是深部组织感染,可促进溃疡发展。如果不及时治疗,很可能造成截肢等后果
伤口世界平台生态圈,以“关爱人间所有伤口患者”为愿景,连接、整合和拓展线上和线下的管理慢性伤口的资源,倡导远程、就近和居家管理慢性伤口,解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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