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Background The association between years of non-diabetes status after diagnosis of impaired glucose tolerance (IGT) and the risk of long-term death and cardiovascular outcomes needed to be clarified. Methods and findings In this post hoc analysis, we included 540 individuals with IGT who participated in the original Da Qing Diabetes Prevention Study (DQDPS). In the DQDPS, all participants were diagnosed with IGT by a 75 g oral glucose tolerance test and randomized to intervention or control groups with a 6-year lifestyle intervention trial. After the completion of the trial, death, cardiovascular events, and microvascular complications were monitored over a 30-year follow-up. In this post hoc analysis, the Cox analysis assessed the extended risk of these outcomes in individuals who either remained non-diabetes status or progressed to diabetes at the end of 2, 4, and 6 years after diagnosis of IGT. In all participants, the difference in the cumulative incidence rate of the outcomes between the diabetes and non-diabetes group gradually increased over 30 years. Compared with the diabetes group, a significantly lower risk of all-cause death (hazard ratio [HR]: 0.74; 95% confidence interval [CI]: 0.57 to 0.97, p = 0.026), cardiovascular events (HR: 0.63; 95% CI: 0.49 to 0.82, p < 0.001), and microvascular complications (HR: 0.62; 95% CI: 0.45 to 0.86, p = 0.004) first emerged in individuals who remained non-diabetes at the 4 years visit, whereas the significant risk reduction in cardiovascular death was first observed at the end of 6 years (HR: 0.56; 95% CI: 0.39 to 0.81, p = 0.002) after adjustment for age, sex, smoking status, BMI, systolic blood pressure, blood glucose, total cholesterol, intervention, and medications (including insulin plus oral hypoglycaemics, antihypertensives, and lipid-lowering agents). The results in the original intervention group alone were similar to the whole group. The main limitations of our study are the limited number of participants and the sole ethnicity of the Chinese population. Conclusions In this study, we observed that maintaining several years of non-diabetes status after IGT diagnosis was associated with a significant reduction in long-term risk of death and vascular complications, and for most of these outcomes, maintaining at least 4 years of non-diabetes status may be needed to achieve a significant risk reduction., Author(s): Xin Qian 1, Jinping Wang 2, Qiuhong Gong 1, Yali An 1, Xinxing Feng 1, Siyao He 1, Xiaoping Chen 3, Wenjuan Wang 4, Lihong Zhang 1, Yuanchi Hui [...]

Objective To explore the effect of glucagon-like peptide-1 receptor agonist (GLP-1RA) on cardiovascular risk in overweight/obese type 2 diabetic patients complicated with coronary heart disease. Methods A retrospective study was proceeded in 200 overweight/obese diabetic patients with coronary heart disease at Fuwai Hospital from October 2010 to October 2016. Patients were divided into GLP-1RA treatment group (n=105) and the conventional treatment group (n=95). Data of body weight, body mass index (BMI), glycated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG) and blood lipids before and after treatment for 6 months or drug withdrawal after 30 months were analyzed. The incidence rates of recurrent cardiovascular events / the cardiovascular risks were also evaluated between these 2 groups. Kruskal-Wallis test was used to compare the continuous variables in non-normal distribution, Student-t test was used to compare the continuous variables in normal distribution, and paired t-test was used to analyze the follow-up data and baseline data. Chi-Square test was used to compare the classified variable between groups. Multivariate Logistic regression analysis was used to analyze the related risk factors of cardiovascular events. Results Weight [(-5.7±4.0) vs (-1.3±2.4)kg], BMI [(-1.9±1.3) vs (-0.4±0.7)kg/m²], HbA1c [(-1.5±1.3)% vs (-0.8±0.6)%] and low density lipoprotein cholesterol after 6-month treatment were significantly decreased in GLP-1RA treatment group than those in conventional treatment group (t=2.42 -4.19, all P<0.05). After 30-month following-up, the incidence rates of cardiovascular events in GLP-1RA group were significantly lower than those in conventional treatment group [2.86%(3/105) vs 11.58%(11/95), χ²=4.57, P<0.05]. Compared with conventional treatment group after adjustment of multiple risk factors, the risk of recurrent cardiovascular events in GLP-1RA treatment group was significantly decreased (OR:0.23, 95%CI: 0.06-0.89, P=0.04). Conclusion Short-term application of GLP-1RA could alleviate body weight, improve glycolipid metabolic disorder, and reduce the risk of recurrent cardiovascular events in overweight/obese type 2 diabetic patients with coronary heart disease. [ABSTRACT FROM AUTHOR]