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10.1161/HYPERTENSIONAHA.108.119438 http://scihub22266oqcxt.onion/10.1161/HYPERTENSIONAHA.108.119438 18981326!2676425!18981326     free     free     free Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       Hypertension 2008 ; 52 (6): 1022-9 Nephropedia Template TP {{tp|p=18981326|t=2008. Changes in serum potassium mediate thiazide-induced diabetes |pdf=|usr=}}{{18981326}} gab.com Text Changes in serum potassium mediate thiazide-induced diabetes JO: Hypertension http://www.kidney.de/pget.php?&tw=1&pmid=18981326 #FOAvip Thiazides, recommended as first-line antihypertensive therapy, are associated with an increased risk of diabetes. Thiazides also lower serum potassium. To determine whether thiazide-induced diabetes is mediated by changes in potassium, we analyzed data from 3790 nondiabetic participants in the Systolic Hypertension in Elderly Program, a randomized clinical trial of isolated systolic hypertension in individuals aged >or=60 years treated with chlorthalidone or placebo. Incident diabetes was defined by self-report, antidiabetic medication use, fasting glucose >or=126 mg/dL, or random glucose >or=200 mg/dL. The mediating variable was change in serum potassium during year 1. Of the 459 incident cases of diabetes during follow-up, 42% occurred during year 1. In year 1, the unadjusted incidence rates of diabetes per 100 person-years were 6.1 and 3.0 in the chlorthalidone and placebo groups, respectively. In year 1, the adjusted diabetes risk (hazard ratio) with chlorthalidone was 2.07 (95% CI: 1.51 to 2.83; P<0.001). After adjustment for change in serum potassium, the risk was significantly reduced (hazard ratio: 1.54; 95% CI: 1.09 to 2.17; P=0.01); the extent of risk attenuation (41%; 95% CI: 34% to 49%) was consistent with a mediating effect. Each 0.5-mEq/L decrease in serum potassium was independently associated with a 45% higher adjusted diabetes risk (95% CI: 24% to 70%; P<0.001). After year 1, chlorthalidone use was not associated with increased diabetes risk. In conclusion, thiazide-induced diabetes occurs early after initiating treatment and appears to be mediated by changes in serum potassium. Potassium supplementation might prevent thiazide-induced diabetes. This hypothesis can and should be tested in a randomized trial. Twit Text FOAVip Changes in serum potassium mediate thiazide-induced diabetes ????Hypertension http://www.kidney.de/pget.php?&tw=1&pmid=18981326 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=18981326 #FOAvip English Wikipedia <ref>{{Cite pmid|18981326}}</ref> Changes in serum potassium mediate thiazide-induced diabetes #MMPMID18981326 Shafi T; Appel LJ; Miller ER 3rd; Klag MJ; Parekh RS Hypertension 2008[Dec]; 52 (6): 1022-9 PMID18981326show ga Thiazides, recommended as first-line antihypertensive therapy, are associated with an increased risk of diabetes. Thiazides also lower serum potassium. To determine whether thiazide-induced diabetes is mediated by changes in potassium, we analyzed data from 3790 nondiabetic participants in the Systolic Hypertension in Elderly Program, a randomized clinical trial of isolated systolic hypertension in individuals aged >or=60 years treated with chlorthalidone or placebo. Incident diabetes was defined by self-report, antidiabetic medication use, fasting glucose >or=126 mg/dL, or random glucose >or=200 mg/dL. The mediating variable was change in serum potassium during year 1. Of the 459 incident cases of diabetes during follow-up, 42% occurred during year 1. In year 1, the unadjusted incidence rates of diabetes per 100 person-years were 6.1 and 3.0 in the chlorthalidone and placebo groups, respectively. In year 1, the adjusted diabetes risk (hazard ratio) with chlorthalidone was 2.07 (95% CI: 1.51 to 2.83; P<0.001). After adjustment for change in serum potassium, the risk was significantly reduced (hazard ratio: 1.54; 95% CI: 1.09 to 2.17; P=0.01); the extent of risk attenuation (41%; 95% CI: 34% to 49%) was consistent with a mediating effect. Each 0.5-mEq/L decrease in serum potassium was independently associated with a 45% higher adjusted diabetes risk (95% CI: 24% to 70%; P<0.001). After year 1, chlorthalidone use was not associated with increased diabetes risk. In conclusion, thiazide-induced diabetes occurs early after initiating treatment and appears to be mediated by changes in serum potassium. Potassium supplementation might prevent thiazide-induced diabetes. This hypothesis can and should be tested in a randomized trial. |Aged[MESH] |Antihypertensive Agents/administration & dosage/*adverse effects[MESH] |Atenolol/administration & dosage[MESH] |Blood Pressure/drug effects[MESH] |Chlorthalidone/administration & dosage/*adverse effects[MESH] |Diabetes Mellitus, Type 2/*chemically induced/epidemiology[MESH] |Drug Therapy, Combination[MESH] |Female[MESH] |Humans[MESH] |Hypertension/*drug therapy/epidemiology[MESH] |Hypokalemia/*chemically induced/epidemiology[MESH] |Incidence[MESH] |Male[MESH] |Middle Aged[MESH] |Potassium/blood[MESH] |Proportional Hazards Models[MESH] |Reserpine/administration & dosage[MESH]Changes in serum potassium mediate thiazide-induced diabetes (epmc).pdf DeepDyve Pubget Overpricing