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Case-control study of second-line therapies for type 2 diabetes in combination with metformin and the comparative risks of myocardial infarction and stroke.
Diabetes Obes Metab. 2015 Dec; 17(12):1194-7.DO

Abstract

We conducted a population-based case-control study to assess the myocardial infarction (MI) and stroke risks associated with sulphonylureas and insulin when used in combination with metformin. Cases had type 2 diabetes and used metformin + insulin or metformin + sulphonylureas at the time of a first MI or first stroke between 1995 and 2010; controls used the same treatment combinations and were randomly sampled from the same population. MI and stroke diagnoses and potential confounders were validated by medical record reviews. Compared with metformin + sulphonylurea, metformin + insulin was associated with similar risks of MI or stroke [odds ratio 0.98 (95% confidence interval 0.63-1.52)]. Meta-analysis with another observational study improved the precision of the risk estimate [relative risk 0.92 (95% confidence interval 0.69-1.24)]. Current evidence suggests that there may not be large differences in cardiovascular risk associated with the use of insulin or sulphonylureas when used in combination with metformin.

Authors+Show Affiliations

Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA. Department of Medicine, University of Washington, Seattle, WA, USA.Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA.Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA. Department of Medicine, University of Washington, Seattle, WA, USA.Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA. Memorial Sloan Kettering Cancer Center, New York, NY, USA.Department of Epidemiology, University of Washington, Seattle, WA, USA. Group Health Research Institute, Seattle, WA, USA.Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA. Department of Epidemiology, University of Washington, Seattle, WA, USA. Group Health Research Institute, Seattle, WA, USA. Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Office of Research and Development, Seattle, WA, USA.Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA. Department of Epidemiology, University of Washington, Seattle, WA, USA. Group Health Research Institute, Seattle, WA, USA.Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA. Department of Medicine, University of Washington, Seattle, WA, USA. Department of Epidemiology, University of Washington, Seattle, WA, USA. Group Health Research Institute, Seattle, WA, USA.

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26179389

Citation

Floyd, J S., et al. "Case-control Study of Second-line Therapies for Type 2 Diabetes in Combination With Metformin and the Comparative Risks of Myocardial Infarction and Stroke." Diabetes, Obesity & Metabolism, vol. 17, no. 12, 2015, pp. 1194-7.
Floyd JS, Wiggins KL, Sitlani CM, et al. Case-control study of second-line therapies for type 2 diabetes in combination with metformin and the comparative risks of myocardial infarction and stroke. Diabetes Obes Metab. 2015;17(12):1194-7.
Floyd, J. S., Wiggins, K. L., Sitlani, C. M., Flory, J. H., Dublin, S., Smith, N. L., Heckbert, S. R., & Psaty, B. M. (2015). Case-control study of second-line therapies for type 2 diabetes in combination with metformin and the comparative risks of myocardial infarction and stroke. Diabetes, Obesity & Metabolism, 17(12), 1194-7. https://doi.org/10.1111/dom.12537
Floyd JS, et al. Case-control Study of Second-line Therapies for Type 2 Diabetes in Combination With Metformin and the Comparative Risks of Myocardial Infarction and Stroke. Diabetes Obes Metab. 2015;17(12):1194-7. PubMed PMID: 26179389.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Case-control study of second-line therapies for type 2 diabetes in combination with metformin and the comparative risks of myocardial infarction and stroke. AU - Floyd,J S, AU - Wiggins,K L, AU - Sitlani,C M, AU - Flory,J H, AU - Dublin,S, AU - Smith,N L, AU - Heckbert,S R, AU - Psaty,B M, Y1 - 2015/10/05/ PY - 2015/05/31/received PY - 2015/06/20/revised PY - 2015/07/02/accepted PY - 2015/7/17/entrez PY - 2015/7/17/pubmed PY - 2016/8/16/medline KW - cardiovascular outcomes KW - case-control study KW - comparative safety KW - insulin KW - metformin KW - myocardial infarction KW - stroke KW - sulphonylureas SP - 1194 EP - 7 JF - Diabetes, obesity & metabolism JO - Diabetes Obes Metab VL - 17 IS - 12 N2 - We conducted a population-based case-control study to assess the myocardial infarction (MI) and stroke risks associated with sulphonylureas and insulin when used in combination with metformin. Cases had type 2 diabetes and used metformin + insulin or metformin + sulphonylureas at the time of a first MI or first stroke between 1995 and 2010; controls used the same treatment combinations and were randomly sampled from the same population. MI and stroke diagnoses and potential confounders were validated by medical record reviews. Compared with metformin + sulphonylurea, metformin + insulin was associated with similar risks of MI or stroke [odds ratio 0.98 (95% confidence interval 0.63-1.52)]. Meta-analysis with another observational study improved the precision of the risk estimate [relative risk 0.92 (95% confidence interval 0.69-1.24)]. Current evidence suggests that there may not be large differences in cardiovascular risk associated with the use of insulin or sulphonylureas when used in combination with metformin. SN - 1463-1326 UR - https://www.unboundmedicine.com/medline/citation/26179389/Case_control_study_of_second_line_therapies_for_type_2_diabetes_in_combination_with_metformin_and_the_comparative_risks_of_myocardial_infarction_and_stroke_ L2 - https://doi.org/10.1111/dom.12537 DB - PRIME DP - Unbound Medicine ER -