MD Conference Express ADA 2012 - (Page 4)
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F E A T U R E
ORIGIN Trial Proves Safety of Insulin, Lack of Efficacy for n-3 Fatty Acids
Written by Rita Buckley
Gilles Dagenais, MD, Laval University Heart and Lung Institute, Quebec City, Quebec, Canada, and Ambady Ramachandran, MD, India Diabetes Research Foundation, Chennai, India, presented an overview of the Outcome Reduction With an Initial Glargine Intervention Trial [ORIGIN; NCT00069784]. ORIGIN was a large, international, randomized, controlled trial that lasted >6 years in people with new or recently diagnosed diabetes, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and additional cardiovascular (CV) risk factors. ORIGIN is the longest investigation of the effect of insulin treatment on CV outcomes and cancer incidence in this population to date. The relationship between long-term supplementation with n-3 fatty acids and the rate of CV events was also studied [Gerstein H et al. N Engl J Med 2012]. ORIGIN Trial Design ORIGIN was a double-blind study with a 2-by-2 factorial design. It was designed to test the effect of titrated basal insulin glargine versus standard care, and it also investigated n-3 fatty acid supplements versus placebo on CV outcomes [Gerstein H et al. Am Heart J 2008]. A total of 12,537 participants (mean age, 63.5 years; 35% women) were enrolled from 573 clinical sites in 40 countries. Patients were randomly assigned by region. The median followup was 6.2 years (interquartile range, 5.8 to 6.7 years). At the conclusion of the study, the primary outcome status was known for 99% of participants. Coprimary outcomes in the glargine trial were the first occurrence of nonfatal myocardial infarction (MI) or nonfatal stroke or CV and the first occurrence of nonfatal MI or nonfatal stroke or CV death or hospitalization for heart failure or revascularization. Other outcomes and measures included new or recurrent cancers, angina, ischemia-related amputation, hypoglycemia, and CV and other hospitalizations. n-3 Fatty Acid Trial Results Peer-Reviewed Highlights from the Jacqueline Bosch, MSc, McMaster University, Hamilton, Ontario, Canada, presented results from the n-3 fatty acid portion of the ORIGIN trial. Baseline intake of n-3 fatty acids was 210 mg/day versus 209 mg/day for placebo. At the end of the study, it was 257 mg/day versus 253 mg/day for placebo. The primary outcome of the trial was CV death. Secondary outcomes were MI, stroke or CV death, all-cause mortality, presumed arrhythmic death, or cardiac arrest. Patients were randomized to receive a daily supplement of n-3 fatty acid (1g per day) or placebo. The primary outcome of the trial was CV death. Secondary outcomes were MI, stroke or CV death, all cause mortality, presumed arrhythmic death, or cardiac arrest.
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August 2012
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Table of Contents for the Digital Edition of MD Conference Express ADA 2012
MD Conference Express ADA 2012
Contents
ORIGIN Trial Results
New Lessons in Hypertension and Diabetes
Closed-Loop Insulin Therapy in Young Children
The Precocious “AGE’ing” Effect of Type 1 Diabetes in Children
Abatacept in Patients with New-Onset Type 1 Diabetes: One-Year Follow-Up
Explaining the UKPDS Legacy Effect
Insulin and Cancer
Insulin Analogs
Dyslipidemia
Insulin Therapy
Incretin Therapies
Diabetes and Chronic Kidney Disease Guidelines Update
Managing Hyperglycemia in Hospitalized Patients
CVD Prevention and Treatment in Women With Diabetes
China Da Qing Study: Lifestyle Change in Women With IGT Extends Life
Markers of Macrovascular Complications in Pediatric Diabetes
Nonoperative Management of the Infected Diabetic Foot
Diabetic Retinopathy: Changing Prevalence and Severity Require Flexible Interventions
New ADA/EASD Position Statement Endorses a Patient-Centered Approach
MD Conference Express ADA 2012
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