- Regression of albuminuria (e.g. via better blood pressure or glycaemic control) was associated with reduction in cardiovascular (CV) events and all-cause mortality in patients with insulin-treated type 2 diabetes (T2D) and nephropathy in routine practice.
Why this matters
- Levels of albuminuria should be considered not only as an important risk marker but also as an important therapeutic target for CV and mortality prevention in patients with T2D.
- Study used data from a large UK Primary Care database (The Health Improvement Network Database) and identified a cohort of insulin users with T2D and nephropathy (baseline urinary albumin-creatinine ratio [ACR] ≥300 mg/g) between 2007 and 2014.
- Cohort was followed up for 5 years for primary endpoints of all-cause mortality and CV events (a composite of non-fatal myocardial infarction and stroke).
- Funding: Medical Research Council and Arthritis Research UK.
- A total of 11,074 patients with insulin-treated T2D (mean age, 62.3 years; mean HbA1c, 8.7% [1.8 mmol/mol]) were included.
- 5-year survival was reduced in patients with ACR >300 mg/g vs those with ACR
- Within a total follow-up period of 43,393 person-time, 682 deaths with a crude incidence rate of 15.7 per 1000 person-years (95% CI, 14.6-17.0) were reported.
- After adjustment, the risks for CV events and all-cause mortality was 27 and 31% lower in patients with ACR
- Residual confounding.