{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T11:55:27Z","timestamp":1783338927197,"version":"3.54.6"},"reference-count":40,"publisher":"American Diabetes Association","issue":"9","license":[{"start":{"date-parts":[[2020,8,20]],"date-time":"2020-08-20T00:00:00Z","timestamp":1597881600000},"content-version":"vor","delay-in-days":49,"URL":"https:\/\/www.diabetesjournals.org\/content\/license"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["513781"],"award-info":[{"award-number":["513781"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1042231"],"award-info":[{"award-number":["1042231"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,9,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To determine whether ACE inhibitors (ACEi) and angiotensin receptor blockers (ARB) protect against lower\u2013respiratory tract infections complicating type 2 diabetes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>Of 1,732 participants with diabetes recruited to the longitudinal observational Fremantle Diabetes Study Phase II (FDS2) between 2008 and 2011, 1,482 had confirmed type 2 diabetes (mean age 65.8 years and median diabetes duration 9.0 years; 51.6% were male). All were followed for hospitalizations for or with, or deaths from, pneumonia\/influenza, ascertained from validated administrative data linkage from study entry to end of 2016. Cox regression and competing risk regression were used to identify independent predictors of this outcome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Two-thirds of participants (n = 982) were taking an ACEi and\/or ARB at study entry (498 [33.6%] ACEi, 408 [27.5%] ARB, 76 [5.1%] both). During 9,511 person-years of follow-up (mean \u00b1 SD 6.4 \u00b1 2.0 years), 174 participants had incident pneumonia\/influenza (156 hospitalizations and 18 deaths without hospitalization). In Cox regression analysis, baseline ACEi\/ARB use was independently associated with a reduced risk of incident pneumonia\/influenza (cause-specific hazard ratio [HR] 0.64 [95% CI 0.45, 0.89], P = 0.008). Allowing for the competing risk of death did not change this finding (subdistribution HR 0.67 [0.48, 0.95], P = 0.024), and similar reductions were seen for ACEi, ARB alone, and ACEi\/ARB combination therapy. There was no significant change in use of ACEi\/ARB during follow-up [interaction with ln(time), P = 0.70]. Other significant predictors of incident pneumonia\/influenza were previously reported, clinically plausible variables.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>ACEi\/ARB reduce the risk of pneumonia\/influenza in people with type 2 diabetes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc20-0895","type":"journal-article","created":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T00:06:06Z","timestamp":1593734766000},"page":"2113-2120","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":10,"title":["Influence of Renin-Angiotensin System Inhibitors on Lower\u2013Respiratory Tract Infections in Type 2 Diabetes: The Fremantle Diabetes Study Phase II"],"prefix":"10.2337","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0749-7411","authenticated-orcid":false,"given":"Timothy 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