INSULIN AND HIGHER ODDS OF A POSITIVE HISTORY OF CARDIOVASCULAR DISEASE AMONG DIABETIC INDIVIDUALS

Author(s)

Geneus CJ, Davis RE
Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA

OBJECTIVES: This study examined associations between positive history of cardiovascular disease (CVD) and insulin, socio-demographic, and psychological determinants among diabetic respondents. METHODS: Data from the 2014 Behavioral Risk Factor Surveillance System (BRFSS) were analyzed for 9,506 self-reported diabetic survey participants aged ≥18 years. Both weighted multivariable and multinomial logistic regression models assessed history of CVD. RESULTS:
The adjusted multivariable model revealed that the odds of a positive self-reported history of CVD were 1.43 (95% CI: 1.22-1.68) times higher among individuals who reported using insulin compared to non-users. Older individuals (aged ≥ 55 years) had higher odds (aOR = 2.72; 95% CI: 1.30-5.67) of history of CVD compared to younger peers (aged 18-24 years). Furthermore, males had higher odds compared to females (OR = 1.35; 95% CI: 1.15-1.60). Interestingly, alcohol users had 21.2% (aOR = 0.79; 95%: 0.66-0.95) lower odds compared lifetime abstainers. Although positive self-reported frequent mental distress (≥14 mentally unhealthy days) (aOR = 1.11; 95% 0.89-1.39) and depression (aOR = 1.10; 95% CI: 0.91-1.33) both increased the odds of a positive self-reported history of CVD, only self-reported physical health (≥30 days of physical health not good) was statistically significant (aOR = 1.64; 95% CI:1.40-1.93).The adjusted multinomial logistic regression model showed that, compared to individuals without a history of CVD, insulin users had higher odds of self-reporting coronary heart
disease (CHD) (aOR = 1.53; 95% CI: 1.22-1.68). Moreover, insulin users had 8% lower odds of self-reporting stroke, (aOR = 0.92; 95%CI: 0.69-1.24) and had 1.30 times (OR = 1.30; 95% CI: 0.94-1.80) higher odds of self-reporting myocardial infarction but such trend were not statistically significant.
CONCLUSIONS: Self-reported diabetic individuals who use insulin had higher odds of a self-reported history of CVD, particularly CHD. Future research should determine whether other medical and cardiometabolic mechanisms interact with insulin to better understand CVD outcomes.

Conference/Value in Health Info

2016-05, ISPOR 2016, Washington DC, USA

Value in Health, Vol. 19, No. 3 (May 2016)

Code

PCV7

Topic

Epidemiology & Public Health

Disease

Cardiovascular Disorders, Diabetes/Endocrine/Metabolic Disorders

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