Sulphonylurea compared to DPP-4 inhibitors in combination with metformin carries increased risk of severe hypoglycemia, cardiovascular events, and all-cause mortality

↓ Direkt till sidans innehåll
↓ Direkt till sidans sekundära innehåll (sidomenyn)

Sökning: L773:0168 8227 > Sulphonylurea compa...

Eriksson, Jan W.Uppsala universitet,Klinisk diabetologi och metabolism (författare)

Sulphonylurea compared to DPP-4 inhibitors in combination with metformin carries increased risk of severe hypoglycemia, cardiovascular events, and all-cause mortality

Artikel/kapitelEngelska2016

Förlag, utgivningsår, omfång ...

Elsevier BV,2016
electronicrdacarrier

Nummerbeteckningar

LIBRIS-ID:oai:DiVA.org:uu-299700
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-299700URI
https://doi.org/10.1016/j.diabres.2016.04.055DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:133779159URI

Kompletterande språkuppgifter

Språk:engelska
Sammanfattning på:engelska

Ingår i deldatabas

SwePubSwePub

Klassifikation

Ämneskategori:ref swepub-contenttype
Ämneskategori:art swepub-publicationtype

Anmärkningar

Aims: There are safety concerns related to sulphonylurea treatment. The objective of this nationwide study was to compare the risk of cardiovascular disease (CVD), all-cause mortality and severe hypoglycemia in patients with type 2 diabetes (T2D) starting second-line treatment with either metformin + sulphonylurea or metformin + dipeptidyl peptidase-4 inhibitor (DPP-4i). Methods: All patients with T2D in Sweden who initiated second-line treatment with metformin + sulphonylurea or metformin + DPP-4i during 2006-2013 (n = 40,736 and 12,024, respectively) were identified in this nationwide study. The Swedish Prescribed Drug Register and the Cause of Death and National Patient Registers were used, and Cox survival models adjusted for age, sex, fragility, prior CVD, and CVD-preventing drugs were applied to estimate risks of events. Propensity score adjustments and matching methods were used to test the results. Results: Of 52,760 patients; 77% started metformin + SU and 23% metformin + DPP-4i. Crude incidences for severe hypoglycemia, CVD, and all-cause mortality in the SU cohort were 2.0, 19.6, and 24.6 per 1000 patient-years and in the DPP-4i cohort were 0.8, 7.6, and 14.9 per 1000 patient-years, respectively. Sulphonylurea compared with DPP4i was associated with higher risk of subsequent severe hypoglycemia, fatal and nonfatal CVD, and all-cause mortality; adjusted HR (95% CI): 2.07 (1.11-3.86); 1.17 (1.01-1.37); and 1.25 (1.02-1.54), respectively. Results were confirmed by additional propensity-adjusted and matched analyses. Among the SU drugs, glibenclamide had the highest risks. Conclusions: Metformin + SU treatment was associated with an increased risk of subsequent severe hypoglycemia, cardiovascular events, and all-cause mortality compared with metformin + DPP4i. Results from randomized trials will be important to elucidate causal relationships.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Endokrinologi och diabetes hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Endocrinology and Diabetes hsv//eng
Epidemiology
Sulfonylurea
DPP-4i
Hypoglycemia
Cardiovascular disease
All-cause mortality

Biuppslag (personer, institutioner, konferenser, titlar ...)

Bodegard, JohanAstraZeneca Nordic Baltic, Sodertalje, Sweden. (författare)
Nathanson, DavidKarolinska Institutet (författare)
Thuresson, MarcusStatisticon AB, Uppsala, Sweden. (författare)
Nyström, ThomasKarolinska Institutet (författare)
Norhammare, AnnaKarolinska Inst, Dept Med, Cardiol Unit, Stockholm, Sweden. (författare)
Uppsala universitetKlinisk diabetologi och metabolism (creator_code:org_t)

Sammanhörande titlar

Ingår i:Diabetes Research and Clinical Practice: Elsevier BV117, s. 39-470168-82271872-8227

Internetlänk

Hitta via bibliotek

Diabetes Research and Clinical Practice (Sök värdpublikationen i LIBRIS)

Till lärosätets databas

Hitta mer i SwePub

Av författaren/redakt...: Eriksson, Jan W.; Bodegard, Johan; Nathanson, David; Thuresson, Marcu ...; Nyström, Thomas; Norhammare, Anna

Om ämnet

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Endokrinologi oc ...

Artiklar i publikationen: Diabetes Researc ...

Av lärosätet: Uppsala universitet; Karolinska Institutet

Sök utanför SwePub

Sök vidare i:: Google; Google Book Search; Google Scholar

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

LIBRIS.kb.se