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Kassem S, Khalaila B, Stein N, Saliba W, Zaina A. Efficacy, adherence and persistence of various glucagon-like peptide-1 agonists: nationwide real-life data. Diabetes Obes Metab 2024; 26:4646-4652. [PMID: 39109455 DOI: 10.1111/dom.15828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/04/2024] [Accepted: 07/07/2024] [Indexed: 09/19/2024]
Abstract
AIM The management of type 2 diabetes mellitus has advanced in the last two decades since the introduction of glucagon-like peptide-1 receptor agonists (GLP-1RAs). However, multiple factors may interfere with achieving better glycaemic control. This study evaluated the differences between various GLP-1RAs in efficacy, adherence and persistence. MATERIALS AND METHODS We conducted a retrospective cohort study using the electronic medical database from Clalit Health Services. Adults with type 2 diabetes mellitus who purchased any GLP-1RA between 2009 and 2021 were included. The Index Date was defined as the date of the first purchase of any GLP-1RA. We evaluated the adherence, persistence and glycaemic control after GLP-1RAs initiation. Baseline glycaemic and post-treatment glycaemic controls were analysed. RESULTS In total, 70 654 patients were included. The mean age was 11.7 ± 60.4, and 51% were females. A significant reduction in glycated haemoglobin (HbA1c) was observed in all patients who received GLP-1RAs. However, the percentage of changes in the HbA1c was higher among weekly GLP-1RA than daily initiators (14.6% vs. 10.2%, p < 0.001). The proportion of subjects with any decrease in HbA1c was higher among the once-weekly compared with the daily dose (82.4% vs. 74.7%) and mainly patients initiated semaglutide or dulaglutide, with 16.0% and 14.7% reduction. The frequency of good adherence (the proportion of days covered ≥80%) was significantly higher among the weekly group odds ratio = 1.25 (95% confidence interval 1.21-1.28). Good adherence was reported in older age, female gender, Jewish ethnicity and high socio-economic status (p < 0.001). CONCLUSIONS Weekly GLP-1RAs initiators were more adherent, persistent to therapy and achieved better glycaemic control. Epidemiological variables might play a role in achieving this goal.
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Affiliation(s)
- Sameer Kassem
- Department of Internal Medicine, Carmel Medical Center, Haifa, Israel
- Department of Internal Medicine, Ruth and Bruce Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel
| | - Buthaina Khalaila
- Department of Internal Medicine, Ruth and Bruce Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel
- Department of Clinical Pharmacology and Regulatory Management, Carmel Medical Center, Haifa, Israel
| | - Nili Stein
- Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel
- Department of Community Medicine and Epidemiology, Statistical Unit, Lady Davis Carmel Medical Center, Haifa, Israel
| | - Walid Saliba
- Department of Internal Medicine, Ruth and Bruce Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel
- Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel
- Translational Epidemiology Unit and Research Authority, Lady Davis Carmel Medical Center, Haifa, Israel
| | - Adnan Zaina
- Division of Endocrinology and Metabolism, Clalit Medical Health Care Services, Haifa, Israel
- Division of Endocrinology and Metabolism, Bar-Ilan University, The Azrieli Faculty of Medicine, Safed, Israel
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2
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Giandalia A, Nicolucci A, Modugno M, Lucisano G, Rossi MC, Manicardi V, Rocca A, Di Cianni G, Di Bartolo P, Candido R, Cucinotta D, Russo GT. Temporal trends in the starting of insulin therapy in type 2 diabetes in Italy: data from the AMD Annals initiative. J Endocrinol Invest 2024; 47:2087-2096. [PMID: 38441838 PMCID: PMC11266210 DOI: 10.1007/s40618-024-02306-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/09/2024] [Indexed: 07/25/2024]
Abstract
AIMS Opportunities and needs for starting insulin therapy in Type 2 diabetes (T2D) have changed overtime. We evaluated clinical characteristics of T2D subjects undergoing the first insulin prescription during a 15-year-observation period in the large cohort of the AMD Annals Initiative in Italy. METHODS Data on clinical and laboratory variables, complications and concomitant therapies and the effects on glucose control after 12 months were evaluated in T2D patients starting basal insulin as add-on to oral/non-insulin injectable agents, and in those starting fast-acting in add-on to basal insulin therapy in three 5-year periods (2005-2019). RESULTS We evaluated data from 171.688 T2D subjects who intensified therapy with basal insulin and 137.225 T2D patients who started fast-acting insulin. Overall, intensification with insulin occurred progressively earlier over time in subjects with shorter disease duration. Moreover, the percentage of subjects with HbA1c levels > 8% at the time of basal insulin initiation progressively decreased. The same trend was observed for fast-acting formulations. Clinical characteristics of subjects starting insulin did not change in the three study-periods, although all major risk factors improved overtime. After 12 months from the starting of basal or fast-acting insulin therapy, mean HbA1c levels decreased in all the three investigated time-periods, although mean HbA1c levels remained above the recommended target. CONCLUSIONS In this large cohort of T2D subjects, a progressively earlier start of insulin treatment was observed during a long observation period, suggesting a more proactive prescriptive approach. However, after 12 months from insulin prescription, in many patients, HbA1c levels were still out-of-target.
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Affiliation(s)
- A Giandalia
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98100, Messina, Italy.
| | - A Nicolucci
- Center for Outcomes Research and Clinical Epidemiology, CORESEARCH, Pescara, Italy
| | - M Modugno
- ASLBA-DSS10 Poliambulatorio, Triggiano, BA, Italy
| | - G Lucisano
- Center for Outcomes Research and Clinical Epidemiology, CORESEARCH, Pescara, Italy
| | - M C Rossi
- Center for Outcomes Research and Clinical Epidemiology, CORESEARCH, Pescara, Italy
| | | | - A Rocca
- SS Diabetes and Metabolic disease, Bassini Hospital Cinisello Balsamo, Milan, Italy
| | - G Di Cianni
- Diabetes and Metabolic Diseases Unit, Livorno Hospital, Livorno, Italy
| | - P Di Bartolo
- Diabetes Unit, Local Healthcare Authority of Romagna, Ravenna, Italy
| | - R Candido
- SS Diabetes and Metabolic disease, Bassini Hospital Cinisello Balsamo, Milan, Italy
- Azienda Sanitaria Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
| | - D Cucinotta
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98100, Messina, Italy
| | - G T Russo
- Department of Clinical and Experimental Medicine, University of Messina, Via C. Valeria, 98100, Messina, Italy
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Bashir M, Thani N, Khalid A, Khalil O, Alamer Z, Hamad M, Karuppasamy G, Abufaeid M, Elbidairi M, Al‐Mohnnadi D, Elhadd T, Zirie M. Insulin Inertia Among People With Type 2 Diabetes Mellitus in Qatar: The INERT-Q Study. Endocrinol Diabetes Metab 2024; 7:e00495. [PMID: 38844642 PMCID: PMC11156521 DOI: 10.1002/edm2.495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 04/23/2024] [Accepted: 05/07/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND Achieving and maintaining adequate glycaemic control is critical to reduce diabetes-related complications. Therapeutic inertia is one of the leading causes of suboptimal glycaemic control. AIM To assess the degree of inertia in insulin initiation and intensification in people with Type 2 diabetes mellitus (DM-2). METHODS We performed a retrospective longitudinal cohort study and followed DM-2 2 years before and 2 years after the start of insulin. The primary outcome was the proportion of patients who achieved glycaemic targets (HBA1c ≤ 7.5%) at 6th month, 1st year and 2nd year. RESULTS We included 374 predominantly male subjects (62%). The mean age was 55.3 ± 11.3 years, the mean duration of DM-2 was 12.0 ± 7.3 years, 64.4% were obese, 47.6% had a microvascular disease, and 24.3% had a macrovascular disease. The mean HBA1c at -2nd year and -1st year was 9.2 ± 2.1% and 9.3 ± 2.0%, respectively. The mean HbA1C at the time of insulin initiation was 10.4 ± 2.1%. The mean HBA1c at 6th month, 12th month and 2nd year was 8.5 ± 1.8%, 8.4 ± 1.8% and 8.5 ± 1.7%, respectively. The proportion of subjects who achieved HBA1c targets at 6th month, 12th month and 2nd year was 32.9%, 31.0% and 32.9%, respectively. Multivariate logistic regression analysis showed that achieving HBA1c targets at 6th month and 1st year increases the odds of achieving HBA1c targets at 2nd year (OR 4.87 [2.4-9.6] p < 0.001) and (OR 6.2 [3.2-12.0], p < 0.001), respectively. CONCLUSION In people with DM-2, there was an alarming delay in starting and titrating insulin. The reduction in HBA1c plateaued at 6th month. Earlier initiation and intensification of insulin therapy are critical to achieving glycaemic targets. More studies are needed to examine the causes of therapeutic inertia from physicians', patients' and systems' points of view.
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Affiliation(s)
- Mohammed Bashir
- Endocrine Section, Internal Medicine DepartmentHamad Medical CorporationDohaQatar
- Qatar Metabolic InstitutesHamad Medical CorporationDohaQatar
| | - Noora Al Thani
- Endocrine Section, Internal Medicine DepartmentHamad Medical CorporationDohaQatar
| | - Abeer Khalid
- Endocrine Section, Internal Medicine DepartmentHamad Medical CorporationDohaQatar
| | - Obada Khalil
- Endocrine Section, Internal Medicine DepartmentHamad Medical CorporationDohaQatar
| | - Zaina Alamer
- Endocrine Section, Internal Medicine DepartmentHamad Medical CorporationDohaQatar
| | - Mohammed Khair Hamad
- Endocrine Section, Internal Medicine DepartmentHamad Medical CorporationDohaQatar
| | - Gowri Karuppasamy
- Endocrine Section, Internal Medicine DepartmentHamad Medical CorporationDohaQatar
| | - Mohammed Abufaeid
- Endocrine Section, Internal Medicine DepartmentHamad Medical CorporationDohaQatar
| | | | - Dhabia Al‐Mohnnadi
- Endocrine Section, Internal Medicine DepartmentHamad Medical CorporationDohaQatar
| | - Tarik Elhadd
- Endocrine Section, Internal Medicine DepartmentHamad Medical CorporationDohaQatar
| | - Mahmoud Zirie
- Endocrine Section, Internal Medicine DepartmentHamad Medical CorporationDohaQatar
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4
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Buzzetti R, Candido R, Esposito K, Giaccari A, Mannucci E, Nicolucci A, Russo GT. Open questions on basal insulin therapy in T2D: a Delphi consensus. Acta Diabetol 2024:10.1007/s00592-024-02285-2. [PMID: 38767675 DOI: 10.1007/s00592-024-02285-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/07/2024] [Indexed: 05/22/2024]
Abstract
AIMS The revolution in the therapeutic approach to type 2 diabetes (T2D) requires a rethinking of the positioning of basal insulin (BI) therapy. Given the considerable number of open questions, a group of experts was convened with the aim of providing, through a Delphi consensus method, practical guidance for doctors. METHODS A group of 6 experts developed a series of 29 statements on: the role of metabolic control in light of the most recent guidelines; BI intensification strategies: (1) add-on versus switch; (2) inertia in starting and titrating; (3) free versus fixed ratio combination; basal-bolus intensification and de-intensification strategies; second generation analogues of BI (2BI). A panel of 31 diabetologists, by accessing a dedicated website, assigned each statement a relevance score on a 9-point scale. The RAND/UCLA Appropriateness Method was adopted to assess the existence of disagreement among participants. RESULTS Panelists showed agreement for all 29 statements, of which 26 were considered relevant, one was considered not relevant and two were of uncertain relevance. Panelists agreed that the availability of new classes of drugs often allows the postponement of BI and the simplification of therapy. It remains essential to promptly initiate and titrate BI when required. BI should always, unless contraindicated, be started in addition to, and not as a replacement, for ongoing treatments with cardiorenal benefits. 2BIs should be preferred for their pharmacological profile, greater ease of self-titration and flexibility of administration. CONCLUSION In a continuously evolving scenario, BI therapy still represents an important option in the management of T2D patients.
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Affiliation(s)
- Raffaella Buzzetti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Riccardo Candido
- Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Katherine Esposito
- Department of Advanced Medical and Surgical Sciences, Università della Campania "Luigi Vanvitelli", Naples, Italy
| | - Andrea Giaccari
- Center for Endocrine and Metabolic Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
| | - Edoardo Mannucci
- Diabetology, Careggi Hospital and University of Florence, Florence, Italy
| | - Antonio Nicolucci
- CORESEARCH - Center for Outcomes Research and Clinical Epidemiology, Corso Umberto I, 103, 65122, Pescara, Italy.
| | - Giuseppina T Russo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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5
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Seidu S, Alabraba V, Davies S, Newland-Jones P, Fernando K, Bain SC, Diggle J, Evans M, James J, Kanumilli N, Milne N, Viljoen A, Wheeler DC, Wilding JPH. SGLT2 Inhibitors - The New Standard of Care for Cardiovascular, Renal and Metabolic Protection in Type 2 Diabetes: A Narrative Review. Diabetes Ther 2024; 15:1099-1124. [PMID: 38578397 PMCID: PMC11043288 DOI: 10.1007/s13300-024-01550-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/06/2024] [Indexed: 04/06/2024] Open
Abstract
A substantial evidence base supports the use of sodium-glucose cotransporter-2 inhibitors (SGLT2is) in the treatment of type 2 diabetes mellitus (T2DM). This class of medicines has demonstrated important benefits that extend beyond glucose-lowering efficacy to protective mechanisms capable of slowing or preventing the onset of long-term cardiovascular, renal and metabolic (CVRM) complications, making their use highly applicable for organ protection and the maintenance of long-term health outcomes. SGLT2is have shown cost-effectiveness in T2DM management and economic savings over other glucose-lowering therapies due to reduced incidence of cardiovascular and renal events. National and international guidelines advocate SGLT2i use early in the T2DM management pathway, based upon a plethora of supporting data from large-scale cardiovascular outcome trials, renal outcomes trials and real-world studies. While most people with T2DM would benefit from CVRM protection through SGLT2i use, prescribing hesitancy remains, potentially due to confusion concerning their place in the complex therapeutic paradigm, variation in licensed indications or safety perceptions/misunderstandings associated with historical data that have since been superseded by robust clinical evidence and long-term pharmacovigilance reporting. This latest narrative review developed by the Improving Diabetes Steering Committee (IDSC) outlines the place of SGLT2is within current evidence-informed guidelines, examines their potential as the standard of care for the majority of newly diagnosed people with T2DM and sets into context the perceived risks and proven advantages of SGLT2is in terms of sustained health outcomes. The authors discuss the cost-effectiveness case for SGLT2is and provide user-friendly tools to support healthcare professionals in the correct application of these medicines in T2DM management. The previously published IDSC SGLT2i Prescribing Tool for T2DM Management has undergone updates and reformatting and is now available as a Decision Tool in an interactive pdf format as well as an abbreviated printable A4 poster/wall chart.
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Affiliation(s)
- Samuel Seidu
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
| | - Vicki Alabraba
- Leicester Diabetes Centre, University Hospitals Leicester NHS Trust, Leicester, UK
| | | | | | | | - Stephen C Bain
- Diabetes Research Group, Swansea University Medical School, Swansea University, Swansea, UK
- Department of Diabetes and Endocrinology, Singleton Hospital, Swansea Bay University Health Board, Swansea, UK
| | - Jane Diggle
- College Lane Surgery, Ackworth, West Yorkshire, UK
| | - Marc Evans
- University Hospital Llandough, Cardiff, UK
| | - June James
- Leicester Diabetes Centre, University Hospitals Leicester NHS Trust, Leicester, UK
| | - Naresh Kanumilli
- Brooklands Northenden Primary Care Network, Manchester, UK
- Manchester University Foundation Trust, Manchester, UK
| | - Nicola Milne
- Brooklands Northenden Primary Care Network, Manchester, UK
| | - Adie Viljoen
- Borthwick Diabetes Research Unit, Lister Hospital, Stevenage, UK
| | - David C Wheeler
- Department of Renal Medicine, University College London, London, UK
| | - John P H Wilding
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Clinical Sciences Centre, Aintree University Hospital, University of Liverpool, Liverpool, UK.
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6
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AlHarbi M, Othman A, Nahari AA, Al-Jedai AH, Cuadras D, Almalky F, AlAzmi F, Almudaiheem HY, AlShubrumi H, AlSwat H, AlSahafi H, Sindi K, Basaikh K, AlQahtani M, Lamotte M, Yahia M, Hassan MEK, AlMutlaq M, AlRoaly M, AlZelaye S, AlGhamdi Z. Burden of Illness of Type 2 Diabetes Mellitus in the Kingdom of Saudi Arabia: A Five-Year Longitudinal Study. Adv Ther 2024; 41:1120-1150. [PMID: 38240948 PMCID: PMC10879361 DOI: 10.1007/s12325-023-02772-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/13/2023] [Indexed: 02/22/2024]
Abstract
INTRODUCTION Type 2 diabetes mellitus (T2DM) is associated with huge clinical and economic burden in the Kingdom of Saudi Arabia (KSA) which can be curtailed by efficacious treatment. In order to achieve this, current treatment pathways for T2DM and associated costs need to be assessed. METHODS A longitudinal cohort review was conducted to collect country-specific and patient-specific clinical data, over a minimum observation period of 5 years in the KSA. Patient demographics, clinical characteristics and treatment patterns were recorded. The IQVIA Core Diabetes Model (CDM) version 9.5 Plus was used to assess the burden of illness, which included long-term projections of clinical (life expectancy [LE], quality-adjusted life-years [QALYs], event rates of diabetes-related complications) and direct medical cost (per-patient annual or lifelong [50 years]) outcomes of the most commonly used first-line (1st-line) regimens for T2DM from a payer perspective in the KSA. RESULTS Data were collected from a subpopulation of 638 patients from 15 participating centres. There was an equal gender representation with a majority of the patients belonging to Arabian/Saudi ethnicity (71.0%). Biguanides (81.5%), sulfonylureas (51.6%), dipeptidyl peptidase 4 (DPP4) inhibitors (26.2%) and fast-acting insulins (17.2%) were the most prescribed 1st-line agents. The most frequently used 1st-line regimens resulted in an estimated LE of 25-28 years, QALYs of 18-21 years and lifelong total cost of illness of 201,377-437,371 Saudi Arabian riyal (53,700-116,632 US dollars). CONCLUSION Our study addresses gaps in the current research by providing a complete landscape of baseline demographic, clinical characteristics and treatment patterns from a heterogeneous group of patients with T2DM in the KSA. Additionally, the burden of illness analysis using CDM showed substantially higher cost of T2DM care from a payer perspective in the KSA.
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Affiliation(s)
| | - Abdullah Othman
- Aseer Central Hospital, Aseer Diabetes Centre, Abha, Saudi Arabia
| | | | | | | | - Faisal Almalky
- Diabetology Center, Al Noor Specialist Hospital, Makkah, Saudi Arabia
| | - Fayez AlAzmi
- Endocrine and Diabetes Specialized Center, Al-Qurayyat General Hospital, Qurayyat, Saudi Arabia
| | | | - Hamad AlShubrumi
- Buraidah Diabetes Centre, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Hameed AlSwat
- King Abdulaziz Specialized Hospital, Taif, Saudi Arabia
| | - Homaid AlSahafi
- Diabetes and Endocrinology Center, Hera General Hospital, Makkah, Saudi Arabia
| | | | - Khadija Basaikh
- Endocrine and Diabetes Center, King Abdulaziz Hospital, Jeddah, Saudi Arabia
| | - Majed AlQahtani
- Diabetes Center, King Fahad Specialized Hospital, Tabuk, Saudi Arabia
| | | | | | | | | | - Mohammed AlRoaly
- Endocrine and Diabetic Center, King Abdulaziz Specialist Hospital, Jouf, Saudi Arabia
| | - Somaya AlZelaye
- Center of Endocrinology and Diabetes Mellitus, Al-Qunfudah General Hospital, Al-Qunfudah, Makkah Province, Saudi Arabia
| | - Zein AlGhamdi
- Diabetes Centre at King Fahad Hospital, Madina, Saudi Arabia
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7
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Tang LT, Feng L, Cao HY, Shi R, Luo BB, Zhang YB, Liu YM, Zhang J, Li SY. Investigation of the causal relationship between inflammatory bowel disease and type 2 diabetes mellitus: a Mendelian randomization study. Front Genet 2024; 15:1325401. [PMID: 38435063 PMCID: PMC10904574 DOI: 10.3389/fgene.2024.1325401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
Background: Type 2 diabetes mellitus (T2DM) and inflammatory bowel disease (IBD) have been associated, according to various epidemiological research. This study uses Mendelian randomization (MR) to investigate the causal link between T2DM and IBD. Methods: To investigate the causal relationship between IBD and T2DM risk using European population data from the genome-wide association study (GWAS) summary datasets, we constructed a two-sample MR study to evaluate the genetically predicted impacts of liability towards IBD outcomes on T2DM risk. As instrumental variables (IVs), we chose 26 single nucleotide polymorphisms (SNPs) associated with IBD exposure data. The European T2DM GWAS data was obtained from the IEU OpenGWAS Project database, which contains 298,957 cases as the outcome data. The causal relationship between T2DM and IBD using a reverse MR analysis was also performed. Results: The two-sample MR analysis, with the Bonferroni adjustment for multiple testing, revealed that T2DM risk in Europeans is unaffected by their IBD liability (odds ratio (OR): 0.950-1.066, 95% confidence interval (CI): 0.885-1.019, p = 0.152-0.926). The effects of liability to T2DM on IBD were not supported by the reverse MR analysis either (OR: 0.739-1.131, 95% confidence interval (CI): 0.651-1.100, p = 0.058-0.832). MR analysis of IBS on T2DM also have no significant causal relationship (OR: 0.003-1.007, 95% confidence interval (CI): 1.013-5.791, p = 0.069-0.790). FUMA precisely mapped 22 protein-coding genes utilizing significant SNPs of T2DM acquired from GWAS. Conclusion: The MR study showed that the existing evidence did not support the significant causal effect of IBD on T2DM, nor did it support the causal impact of T2DM on IBD.
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Affiliation(s)
- Ling-tong Tang
- Department of Clinical Laboratory, Yan’an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, China
| | - Lei Feng
- Department of Clinical Laboratory, Yan’an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, China
| | - Hui-ying Cao
- Department of Clinical Laboratory, Yan’an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, China
| | - Rui Shi
- Department of Clinical Laboratory, Sixth Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Bei-bei Luo
- Department of Clinical Laboratory, Sixth Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yan-bi Zhang
- Department of Clinical Laboratory, Sixth Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yan-mei Liu
- Department of Clinical Laboratory, Yan’an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, China
| | - Jian Zhang
- Department of Clinical Laboratory, Yan’an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, China
| | - Shuang-yue Li
- Department of Clinical Laboratory, Yan’an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, China
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