Pioglitazone Exposure Reduced the Risk of All-Cause Mortality in Insulin-Treated Patients with Type 2 Diabetes Mellitus
| Autor: | James Cheng-Chung Wei, Chii-Min Hwu, Chun-Wei Pan, Hsiang-Chi Wang, Fu-Shun Yen, Chih-Cheng Hsu |
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| Rok vydání: | 2019 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty Endocrinology Diabetes and Metabolism Clinical Biochemistry Population Taiwan 030209 endocrinology & metabolism 030204 cardiovascular system & hematology Biochemistry 03 medical and health sciences 0302 clinical medicine Endocrinology Internal medicine Diabetes mellitus medicine Humans Hypoglycemic Agents Insulin education Aged Retrospective Studies education.field_of_study Pioglitazone business.industry Mortality rate Biochemistry (medical) Hazard ratio Type 2 Diabetes Mellitus Retrospective cohort study Middle Aged medicine.disease Prognosis Survival Rate Diabetes Mellitus Type 2 Drug Therapy Combination Female business Biomarkers medicine.drug Cohort study Follow-Up Studies |
| Zdroj: | The Journal of clinical endocrinology and metabolism. 105(3) |
| ISSN: | 1945-7197 |
| Popis: | Context The long-term safety and benefit of pioglitazone use in combination with insulin are still uncertain. Objective This study compared the risks of all-cause mortality and major cardiovascular (CV) events between pioglitazone users and nonusers receiving insulin therapy. Design, Setting and Patients We conducted a 13-year retrospective cohort study by using data from the population-based National Health Insurance Research Database in Taiwan. A total of 20 376 patients with type 2 diabetes mellitus (T2DM) receiving insulin therapy were enrolled during 2000 to 2012. Overall, the incidence rates of all-cause mortality and CV events were compared between 2579 pioglitazone users and 2579 matched nonusers. Results After adjustment for age, sex, comorbidities, Diabetes Complications Severity Index scores, and drugs used, mortality rates were 30.26 and 15.02 per 1000 person-years for pioglitazone nonusers and users, respectively. The adjusted hazard ratio (aHR) of mortality was 0.47 (95% confidence interval [CI]: 0.38–0.58, P < 0.001) for pioglitazone users compared with nonusers. The aHRs of CV and non-CV deaths were 0.78 (95% CI: 0.51–1.19) and 0.50 (95% CI: 0.38–0.66), respectively. The aHRs of hospitalized coronary artery disease, hospitalized stroke, and incident heart failure were not significantly different between pioglitazone users and nonusers. Conclusions This nationwide cohort study demonstrated that pioglitazone use reduced the risks of all-cause mortality and non-CV death for patients with T2DM undergoing insulin therapy. |
| Databáze: | OpenAIRE |
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