Metformin combined with dipeptidyl peptidase-4 inhibitors or metformin combined with sulfonylureas in patients with type 2 diabetes: A real world analysis of the South Korean national cohort
| Autor: | Sung-Il Cho, Yeon Young Cho |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Type 2 diabetes Hypoglycemia Lower risk Cohort Studies 03 medical and health sciences 0302 clinical medicine Endocrinology Internal medicine Diabetes mellitus Republic of Korea medicine Humans Hypoglycemic Agents 030212 general & internal medicine Aged Retrospective Studies Dipeptidyl-Peptidase IV Inhibitors business.industry Retrospective cohort study Middle Aged medicine.disease Comorbidity Metformin Sulfonylurea Compounds Treatment Outcome Diabetes Mellitus Type 2 Cohort Drug Therapy Combination Female business medicine.drug |
| Zdroj: | Metabolism. 85:14-22 |
| ISSN: | 0026-0495 |
| Popis: | Aims We explored the risks associated with metformin plus sulfonylurea (MET + SU) or MET plus a dipeptidyl peptidase-4 inhibitor (MET + DPP4i) for hypoglycemia, cardiovascular disease (CVD) events and all-cause mortality in type 2 diabetes (T2D) patients with comorbidities. Methods This retrospective cohort study is based on the South Korean National Health Insurance Service–National Sample Cohort, enrolling T2D patients with one or more diabetes-related comorbidities who switched from monotherapy to MET + SU or MET + DPP4i between July 1, 2008 and December 31, 2013. The risk of hypoglycemia, CVD events and all-cause mortality was examined using Cox's proportional hazard modeling and propensity score matching. Results Overall, 5693 patients with a mean of 2.6 comorbidities in addition to diabetes were included. Compared with MET + SU, MET + DPP4i treatment was associated with a lower risk of hypoglycemia, CVD events and all-cause mortality; adjusted HRs (95% CI), 0.39 (0.18–0.83), 0.72 (0.54–0.97), and 0.64 (0.39–1.05), respectively. Propensity score matching showed comparable results. In further subgroup analyses according to comorbidity type and number, MET + DPP4i was associated with less CVD events and all-cause mortality compared to MET + SU. This increased with more complex comorbid status. Conclusions In T2D patients with comorbidities, MET + DPP4i treatment is associated with lower risks of CVD events and all-cause mortality compared with MET + SU, independent of type or number of comorbidities. A more complex comorbid status further increases this effect. |
| Databáze: | OpenAIRE |
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