Progression to insulin for patients with diabetes mellitus on dual oral antidiabetic therapy using the US Department of Defense Database
| Autor: | Debra Lopez, James P. Wilson, Karen L. Rascati, Kristin M. Richards, Lung I. Cheng |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Time Factors endocrine system diseases Databases Factual Endocrinology Diabetes and Metabolism medicine.medical_treatment Administration Oral Endocrinology Diabetes mellitus Internal medicine Internal Medicine medicine Odds Ratio Humans Hypoglycemic Agents Insulin Aged Proportional Hazards Models Retrospective Studies business.industry nutritional and metabolic diseases Retrospective cohort study Odds ratio Middle Aged medicine.disease Confidence interval Metformin United States Regimen Military Personnel Sulfonylurea Compounds Treatment Outcome Diabetes Mellitus Type 2 Cohort Disease Progression Drug Therapy Combination Female Thiazolidinediones business medicine.drug Follow-Up Studies |
| Zdroj: | Diabetes, obesitymetabolism. 15(10) |
| ISSN: | 1463-1326 |
| Popis: | Aim To compare ‘progression to insulin’ for three cohorts on oral antidiabetic medication combinations: metformin/sulphonylurea (Met/SU), metformin/thiazolidinedione (Met/TZD) and sulphonylurea/thiazolidinedione (SU/TZD). Methods Retrospective cohort analysis design was used. The subjects were US nationwide members of military and their families. A total of 5608 patients who were on antidiabetic monotherapy for at least 1 year before adding a second agent to their medication regimen between October 2001 and September 2008 participated in this study. Mean age ranged from 64 to 71 years among the cohorts. Cox regression compared the progression to insulin, adjusting for demographics, months of follow-up and co-morbidities [measured with Chronic Disease Score (CDS)]. Results By the end of the 2- to 6-year follow-up period, 14.3% of the Met/TZD cohort, 23.6% of the Met/SU cohort and 28.2% of the SU/TZD cohort had insulin added to their regimen. Those in the Met/SU cohort had a 1.8 times higher probability of progression to insulin than those in the Met/TZD cohort [odds ratio (OR) = 1.80, 95% confidence interval (CI) = 1.51–2.14), and those in the SU/TZD cohort had a 2.5 times higher probability of progression to insulin than those in the Met/TZD cohort (OR = 2.51, 95% CI = 2.04–3.08). Conclusion When sensitizers were paired (Met/TZD), a lower percentage of patients progressed to insulin during the study period, as opposed to patients who used a combination of a secretagogue with a sensitizer (SU/TZD or Met/SU). |
| Databáze: | OpenAIRE |
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