PATIENTS TREATED WITH INSULIN AND SULPHONYLUREA ARE AT INCREASED MORTALITY RISK AS COMPARED WITH THOSE TREATED WITH INSULIN PLUS METFORMIN

Overview

Journal Acta Endocrinol (Buchar)

Specialty Endocrinology

Date 2019 Jun 1

PMID 31149195

Citations 1

Authors

S Ioacara

C Guja

O Georgescu

S Martin

A Sirbu

M Purcaru

S Fica

Affiliations

Soon will be listed here.

Abstract

Aims: To investigate the effect of sulphonylurea (SU) treatment on all-cause and cardiovascular mortality as compared with metformin (MET), when used in combination with insulin (INS) in type 2 diabetes.

Methods: All type 2 diabetes patients aged ≥40 years were included at their first prescription of INS+MET or INS+SU, during 2001-2008. They were considered at risk until death or December 31, 2011. Mortality rates were calculated per 1000 person-years. Crude and adjusted rate ratios (RR) were calculated using time dependent analysis with INS+MET as reference.

Results: There were 7122 patients (60.8% women) included in the analysis, with a mean age at baseline of 62.0±9.9 years. During the 11 years of study, patients on INS+MET contributed 13620 person-years and 330 deaths (mortality rate 24, CI95% 22-27), while those on INS+SU contributed 8720 person-years and 393 deaths (mortality rate 45, CI95% 41-50). Adjusted all-cause mortality RR were: SU 1.6 (CI95% 1.21-2.11, p<0.001), glimepiride 1.18 (CI95% 0.73-1.91, p=0.51), gliclazide 1.78 (CI95% 1.07-2.95, p=0.024), glibenclamide 1.66 (CI95% 0.71-3.88, p=0.23), glipizide 1.24 (CI95% 0.68-2.27, p=0.49), and gliquidonum 2.32 (CI95% 1.54-3.50, p=0.001).

Conclusions: When combined with insulin as dual therapy, patients treated with SU were at increased mortality risk as compared with insulin + MET.

Citing Articles

OVERTREATMENT AND HYPOGLYCEMIA PREVALENCE IN GERIATRIC PATIENTS WITH TYPE-2 DIABETES IN THE TURKISH POPULATION.

Akin S, Boluk C, Ozgur Y, Aladag N, Gecmez G, Keskin O Acta Endocrinol (Buchar). 2020; 15(3):311-316.

PMID: 32010349 PMC: 6992403. DOI: 10.4183/aeb.2019.311.

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