Pioglitazone increases risk of ischemic heart disease in patients with type 2 diabetes receiving insulin.

Autor: Tsai MH; Division of Infection, Department of Medicine, Tri-Service General Hospital SongShan Branch, National Defense Medical Center, Taipei City 10581, Taiwan., Chien WC; School of Public Health, National Defense Medical Center, Taipei City 11490, Taiwan; Graduate Institute of Life Sciences, National Defense Medical Center, Taipei City 11490, Taiwan; Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei City 11490, Taiwan., Lin HC; Graduate Institute of Pathology and Parasitology, National Defense Medical Center, Taipei City 11490, Taiwan; Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei City 11490, Taiwan; School of Medicine, National Tsing Hua University, Hsinchu City 300044, Taiwan., Chung CH; School of Public Health, National Defense Medical Center, Taipei City 11490, Taiwan; Taiwanese Injury Prevention and Safety Promotion Association, Taipei City 11490, Taiwan., Chen LC; Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan., Huang KY; Graduate Institute of Pathology and Parasitology, National Defense Medical Center, Taipei City 11490, Taiwan., Lin HA; Division of Infection, Department of Medicine, Tri-Service General Hospital SongShan Branch, National Defense Medical Center, Taipei City 10581, Taiwan; Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei 106, Taiwan. Electronic address: shinean0928@gmail.com.
Jazyk: angličtina
Zdroj: Journal of diabetes and its complications [J Diabetes Complications] 2024 Oct 25; Vol. 38 (12), pp. 108898. Date of Electronic Publication: 2024 Oct 25.
DOI: 10.1016/j.jdiacomp.2024.108898
Abstrakt: Aim: Studies evaluating the cardiovascular safety of pioglitazone show inconsistent results and ischemic heart disease (IHD) risks associated with different anti-diabetic drugs added to metformin uncontrolled type 2 diabetes mellitus (T2DM) are not assessed. This study aimed to evaluate IHD risk associated with pioglitazone and/or insulin added to patients with metformin uncontrolled T2DM.
Methods: Data were extracted from the National Health Insurance Research Database of Taiwan. A total of 19,952 patients with T2DM uncontrolled on metformin received pioglitazone and/or insulin added to metformin were included.
Results: Compared to those who never received pioglitazone and/or insulin, patients receiving both insulin and pioglitazone had higher cumulative risk of IHD (adjusted HR [aHR] = 1.911, 95 % confidence interval [CI]: 1.506-2.351), pioglitazone alone (aHR = 1.446, 95 % CI: 1.111-1.775), and insulin alone (aHR = 1.351, 95 % CI: 1.1052-1.684) (all, p < 0.05). Patients who received both pioglitazone and insulin had a higher cumulative risk of IHD than those who received insulin or pioglitazone as well as a similar result in the cumulative defined daily dose (cDDD) of the drugs.
Conclusion: Administering pioglitazone plus insulin to patients with T2DM uncontrolled on metformin may increase the risk of IHD, suggesting that other second-line anti-diabetes drugs may be a better choice for patients with T2DM uncontrolled on metformin.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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