Variability in benefit from intensive insulin therapy on cardiovascular events in individuals with type 1 diabetes: A post hoc analysis of the DCCT/EDIC study
Authors' conclusion
Although INT reduces the risk of MACE in the majority of individuals with type 1 diabetes, benefit varies substantially. These individual differences in the effect of INT underline the necessity for a better understanding of the individual response to intensive treatment.
Study context
- Population
- Individuals with T1D, participants of the DCCT/EDIC study
- Participants
- 1,441 individuals
- Comparison
- Intensive insulin therapy vs conventional therapy
- Primary endpoint
- Treatment effect heterogeneity of INT on MACE
Methodological detailspenalized Cox regression model with treatment-by-covariate interaction terms, individual treatment effect estimation
- Penalized Cox regression model with treatment-by-covariate interaction terms
- Individual treatment effect estimation
Primary result
As reported in the abstract
Predicted to benefit from insulin therapy (INT) for major adverse cardiovascular events (MACE) risk reduction
1279 individuals
89%
Group with no predicted benefit: median absolute reduction (i.e. risk increase), IQR −0.1% to −0.3%
−0.2%
Highest tertile of predicted benefit: median absolute reduction (i.e. risk reduction), IQR 3.8%-10.9%
6.6%
NNT, highest tertile of predicted benefit
15
Further findings
First MACE events
- First MACE events observed
- 120
Benefit of preventing microvascular complications
- Observed benefit stable across all subgroups of predicted MACE benefit
Original publication
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