8 results on '"Sattar N"'
Search Results
2. Care processes in people in remission from type 2 diabetes: A cohort study using the National Diabetes Audit.
- Author
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Holman N, Khunti K, Wild SH, Sattar N, Knighton P, Young B, Gregg EW, Bakhai C, and Valabhji J
- Subjects
- Humans, Cohort Studies, Ethnicity, England epidemiology, Wales epidemiology, Diabetes Mellitus, Type 2 drug therapy, Diabetes Mellitus, Type 2 epidemiology
- Abstract
Aims: People with type 2 diabetes can enter remission but may relapse or develop legacy complications. This analysis assesses whether people with remission from type 2 diabetes continue receiving annual care processes recommended in national guidelines and the potential impacts of formal recognition of remission., Methods: People with type 2 diabetes with and without formal recognition (diagnostic code) of remission, and with and without evidence of remission (HbA
1c < 48 mmol/mol without prescription for glucose-lowering drugs in preceding 26 weeks), included in the 2018/19 National Diabetes Audit (NDA) for England and Wales were followed up to identify care processes received between 1 January 2019 and 31 March 2020., Results: Of the 2,822,145 people with type 2 diabetes in the cohort, 16,460 (0.58%) were coded with remission in the 2018/19 NDA. After adjustment for age, sex, socioeconomic deprivation and ethnicity, people coded with remission were less likely to receive each care process than those without such coding irrespective of HbA1c measurements (relative risk (RR) of receiving all 8 care processes 0.70 (95% CI 0.69-0.72)). For the 339,235 people with evidence of remission, irrespective of diagnostic coding compared to those without such evidence, the RR for receiving all 8 care processes was 0.94 (95% CI 0.93-0.94)., Conclusions: People coded with remission of type 2 diabetes were less likely to receive diabetes care processes than those without such coding. People with evidence of remission had only a slightly reduced likelihood of receiving care processes. Formal recognition of remission may affect the provision or uptake of care processes., (© 2022 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.)- Published
- 2023
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3. Comparison of mortality in people with type 1 and type 2 diabetes by age of diagnosis: an incident population-based study in England and Wales.
- Author
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Holman N, Wild SH, Gregg EW, Valabhji J, Sattar N, and Khunti K
- Subjects
- England epidemiology, Glycated Hemoglobin analysis, Humans, Risk Factors, Wales epidemiology, Diabetes Mellitus, Type 2 diagnosis, Diabetes Mellitus, Type 2 epidemiology
- Abstract
Competing Interests: NH reports funding from Diabetes UK and NHS England and NHS Improvement and the South Asian Health Foundation to support this work. NS reports grant and personal fees from AstraZeneca, Boehringer Ingelheim, and Novartis; grants from Roche Diagnostics; and personal fees from Afimmune, Amgen, Eli Lilly, Hanmi Pharmaceuticals, Merck Sharp & Dohme, Novo Nordisk, Pfizer, and Sanofi, outside the submitted work. JV is National Clinical Director for Diabetes and Obesity at NHS England and NHS Improvement. KK has reports grants from Boehringer Ingelheim, AstraZeneca, Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, and Merck Sharp & Dohme; and personal fees from Amgen, Astrazeneca, Bayer, NAPP Pharmaceuticals, Lilly, Merck Sharp & Dohme, Novartis, Novo Nordisk, Roche, Berlin-Chemie/Menarini Group, Sanofi-Aventis, Servier, and Boehringer Ingelheim. All other authors declare no competing interests or activities that could appear to have influenced the submitted work. Naveed Sattar and Kamlesh Khunti contributed equally to this work.
- Published
- 2022
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4. Completion of annual diabetes care processes and mortality: A cohort study using the National Diabetes Audit for England and Wales.
- Author
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Holman N, Knighton P, OʼKeefe J, Wild SH, Brewster S, Price H, Patel K, Hanif W, Patel V, Gregg EW, Holt RIG, Gadsby R, Khunti K, Valabhji J, Young B, and Sattar N
- Subjects
- Cohort Studies, England epidemiology, Glycated Hemoglobin analysis, Humans, Risk Factors, Wales epidemiology, Diabetes Mellitus, Type 2 therapy
- Abstract
Aim: To conduct an analysis to assess whether the completion of recommended diabetes care processes (glycated haemoglobin [HbA1c], creatinine, cholesterol, blood pressure, body mass index [BMI], smoking habit, urinary albumin, retinal and foot examinations) at least annually is associated with mortality., Materials and Methods: A cohort from the National Diabetes Audit of England and Wales comprising 179 105 people with type 1 and 1 397 790 people with type 2 diabetes, aged 17 to 99 years on January 1, 2009, diagnosed before January 1, 2009 and alive on April 1, 2013 was followed to December 31, 2019. Cox proportional hazards models adjusting for demographic characteristics, smoking, HbA1c, blood pressure, serum cholesterol, BMI, duration of diagnosis, estimated glomerular filtration rate, prior myocardial infarction, stroke, heart failure, respiratory disease and cancer, were used to investigate whether care processes recorded January 1, 2009 to March 31, 2010 were associated with subsequent mortality., Results: Over a mean follow-up of 7.5 and 7.0 years there were 26 915 and 388 093 deaths in people with type 1 and type 2 diabetes, respectively. Completion of five or fewer, compared to eight, care processes (retinal screening not included as data were not reliable) had a mortality hazard ratio (HR) of 1.37 (95% confidence interval [CI] 1.28-1.46) in people with type 1 and 1.32 (95% CI 1.30-1.35) in people with type 2 diabetes. The HR was higher for respiratory disease deaths and lower in South Asian ethnic groups., Conclusions: People with diabetes who have fewer routine care processes have higher mortality. Further research is required into whether different approaches to care might improve outcomes for this high-risk group., (© 2021 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.)
- Published
- 2021
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5. Cohort profile: National Diabetes Audit for England and Wales.
- Author
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Holman N, Knighton P, Wild SH, Sattar N, Dew C, Gregg EW, Khunti K, Valabhji J, and Young B
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Blood Pressure, Child, Child, Preschool, Cohort Studies, Comorbidity, Diabetes Mellitus, Type 1 physiopathology, Diabetes Mellitus, Type 2 physiopathology, England epidemiology, Female, Follow-Up Studies, Glycated Hemoglobin analysis, Humans, Hypoglycemic Agents therapeutic use, Infant, Male, Middle Aged, Quality of Health Care, Treatment Outcome, Wales epidemiology, Young Adult, COVID-19 epidemiology, Clinical Audit, Diabetes Mellitus, Type 1 epidemiology, Diabetes Mellitus, Type 2 epidemiology, SARS-CoV-2
- Abstract
The National Diabetes Audit (NDA) collates and analyses data on the quality and variation in clinical care and outcomes for people with diabetes. It also provides opportunities to assess trends, determinants, and outcomes of diabetes to help guide clinical and public health priorities., Cohort: Between 1 January 2003 and 31 March 2020, a total of 5,280,885 people diagnosed with diabetes were included in at least one NDA data collection. To this date, median follow-up was 12 and 8 years for people with type 1 diabetes and type 2 diabetes respectively. Comparisons with the 2019/20 Quality and Outcomes Framework show it included 98% of adults in England and Wales with diagnosed type 1 and type 2 diabetes. Data include demographic characteristics (age, sex, ethnicity, age at diagnosis, deprivation), risk factors (HbA
1c , blood pressure, cholesterol, body mass index, smoking status) diabetic and cardiovascular complications and deaths., Secondary Analysis: Secondary analyses have included comparisons of HbA1c and blood pressure measurements in cohorts with similar characteristics to the Epidemiology of Diabetes Interventions and Complications study and the UK Prospective Diabetes Study; COVID-19 related mortality in people with type 1 and type 2 diabetes and incidence of type 2 diabetes following admission to intensive care units., Future Plans: Commissioned NDA reports will continue to inform service development in England and Wales. The same data, with or without linkages to other external datasets, are also a rich resource for clinically orientated research., (© 2021 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.)- Published
- 2021
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6. TriMaster: randomised double-blind crossover study of a DPP4 inhibitor, SGLT2 inhibitor and thiazolidinedione as second-line or third-line therapy in patients with type 2 diabetes who have suboptimal glycaemic control on metformin treatment with or without a sulfonylurea-a MASTERMIND study protocol.
- Author
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Angwin C, Jenkinson C, Jones A, Jennison C, Henley W, Farmer A, Sattar N, Holman RR, Pearson E, Shields B, and Hattersley A
- Subjects
- Cross-Over Studies, Dipeptidyl Peptidase 4 therapeutic use, Double-Blind Method, Drug Therapy, Combination, England, Glycated Hemoglobin analysis, Glycemic Control, Humans, Hypoglycemic Agents therapeutic use, Randomized Controlled Trials as Topic, Scotland, State Medicine, Treatment Outcome, Wales, Diabetes Mellitus, Type 2 drug therapy, Dipeptidyl-Peptidase IV Inhibitors therapeutic use, Metformin therapeutic use, Pharmaceutical Preparations, Sodium-Glucose Transporter 2 Inhibitors therapeutic use, Thiazolidinediones therapeutic use
- Abstract
Introduction: Pharmaceutical treatment options for patients with type 2 diabetes mellitus (T2DM) have increased to include multiple classes of oral glucose-lowering agents but without accompanying guidance on which of these may most benefit individual patients. Clinicians lack information for treatment intensification after first-line metformin therapy. Stratifying patients by simple clinical characteristics may improve care by targeting treatment options to those in whom they are most effective. This academically designed and run three-way crossover trial aims to test a stratification approach using three standard oral glucose-lowering agents., Methods and Analysis: TriMaster is a randomised, double-blind, crossover trial taking place at up to 25 clinical sites across England, Scotland and Wales. 520 patients with T2DM treated with either metformin alone, or metformin and a sulfonylurea who have glycated haemoglobin (HbA
1c ) >58 mmol/mol will be randomised to receive 16 weeks each of a dipeptidyl peptidase-4 inhibitor, sodium-glucose co-transporter-2 inhibitor and thiazolidinedione in random order. Participants will be assessed at the end of each treatment period, providing clinical and biochemical data, and their experience of side effects. Participant preference will be assessed on completion of all three treatments. The primary endpoint is HbA1c after 4 months of therapy (allowing a range of 12-18 weeks for analysis). Secondary endpoints include participant-reported preference between the three treatments, tolerability and prevalence of side effects., Ethical Approval: This study was approved by National Health Service Health Research Authority Research Ethics Committee South Central-Oxford A, study 16/SC/0147. Written informed consent will be obtained from all participants. Results will be submitted to a peer-reviewed journal and presented at relevant scientific meetings. A lay summary of results will be made available to all participants., Trial Registration Numbers: 12039221; 2015-002790-38 and NCT02653209., Competing Interests: Competing interests: EP has received Honoraria from Lilly. NS has consulted for Amgen, Astrazeneca, Boehringer Ingelheim, Eli-Lilly, Napp, NovoNordisk, Sanofi and Pfizer and received grant funding from Boehringer Ingelheim. RRH reports research support from AstraZeneca, Bayer and Merck Sharp & Dohme, and personal fees from Bayer, Intarcia, Merck Sharp & Dohme, Novartis and Novo Nordisk outside the submitted work. CJ has consulted for AstraZeneca, Boehringer Ingelheim, NovoNordisk and Sanofi. WH has received grant funding from IQVIA and travel funds from Eisai., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.)- Published
- 2020
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7. Lifelong patterns of BMI and cardiovascular phenotype in individuals aged 60-64 years in the 1946 British birth cohort study: an epidemiological study.
- Author
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Charakida M, Khan T, Johnson W, Finer N, Woodside J, Whincup PH, Sattar N, Kuh D, Hardy R, and Deanfield J
- Subjects
- Adiposity, Body Mass Index, Cardiovascular Diseases epidemiology, Cardiovascular Diseases etiology, Cardiovascular Diseases physiopathology, Carotid Intima-Media Thickness, Cohort Studies, Cross-Sectional Studies, England epidemiology, Female, Health Surveys, Humans, Longitudinal Studies, Male, Middle Aged, Obesity epidemiology, Obesity physiopathology, Overweight epidemiology, Overweight physiopathology, Risk Factors, Scotland epidemiology, Wales epidemiology, Weight Loss, Cardiovascular Diseases prevention & control, Health Promotion, Life Style, Obesity therapy, Overweight therapy, Patient Compliance
- Abstract
Background: Excess body fat is associated with an increase in risk of type 2 diabetes and hypertension in adulthood and these risks can adversely affect progression of arterial disease. We aimed to assess the impact of lifelong patterns of adiposity on cardiovascular risk factors and carotid intima media thickness (cIMT) in later life in participants in the 1946 British birth cohort study., Methods: The National Survey of Health and Development Study was a nationally representative sample of 5362 singleton births to married parents in England, Scotland, and Wales, stratified by social class, during 1 week in March 1946. Our present study is based on the 60% of participants still alive and with a known present address in England, Scotland, or Wales who attended a clinic assessment after invitation aged 60-64 years. We included participants with lifetime adiposity measures, cardiovascular risk factors, and cIMT measured at 60-64 years. Participants were classified as normal weight or overweight or obese at each age (36, 43, 53, and 60-64 years) in adulthood, and childhood overweight was defined. Patterns of BMI change were identified and we used BMI to define adiposity status. We used multivariable linear regression to establish the cross-sectional association of BMI category at age 60-64 years with cIMT, adjusted for various confounders., Findings: We included 1273 (45%) of 2856 participants eligible in 2006-10 (at age 60-64 years) in this study. Compared with normal weight, overweight and obesity were associated with higher cIMT (0·029 mm, 95% CI 0·014-0·043) and systolic blood pressure (7·95 mm Hg, 5·86-10·0). Increased cIMT, systolic blood pressure, leptin, prevalence of diabetes, and reduced adiponectin were all associated with duration of exposure to adult adiposity (p<0·0001 for all). We noted little additional effect of childhood overweight. Individuals who dropped a BMI category in adulthood had lower cIMT (-0·034 mm, -0·056 to -0·013) and leptin concentrations (-0·4 ng/mL, -0·47 to -0·32), even when this change was not maintained, than did those who never lost weight., Interpretation: Longer exposure to high adiposity in adulthood had a cumulative adverse effect on cardiovascular phenotype in later life. Reductions in BMI category, even if not sustained, were associated with decreases in cIMT and improvements in cardiovascular risk-factor profile, suggesting that weight loss, at any age in adulthood, is worthwhile because it might result in long-term cardiovascular benefit., Funding: Medical Research Council and the British Heart Foundation., (Copyright © 2014 Elsevier Ltd. All rights reserved.)
- Published
- 2014
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8. School dinners and markers of cardiovascular health and type 2 diabetes in 13-16 year olds: cross sectional study.
- Author
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Whincup PH, Owen CG, Sattar N, and Cook DG
- Subjects
- Adolescent, Blood Pressure physiology, Cross-Sectional Studies, England, Female, Health Status, Humans, Male, Nutrition Assessment, Nutritional Status, Risk Factors, School Health Services, Social Class, Wales, Biomarkers blood, Cardiovascular Diseases blood, Diabetes Mellitus, Type 2 blood, Diet standards
- Published
- 2005
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- View/download PDF
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