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Comparing the risks of hospitalized heart failure associated with glinide, sulfonylurea, and acarbose use in type 2 diabetes: A nationwide study.
Int J Cardiol. 2017 Feb 01; 228:1007-1014.IJ

Abstract

BACKGROUND

Increasing evidence suggests that certain newer anti-diabetic drugs are associated with an increased risk of hospitalized heart failure (HHF). However, the potential risks associated with the use of sulfonylurea and glinide have not been carefully evaluated.

METHODS

A retrospective cohort study using the Taiwan National Health Insurance claims database was conducted to examine the risks of HHF among newly diagnosed type 2 diabetic patients who initiated glinide, sulfonylurea, or acarbose therapy during 2006-2012. The outcome of interest was hospitalization due to heart failure after treatment initiation, defined by ICD-9-CM code. A Cox proportional hazard regression model was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) using acarbose as the reference group.

RESULTS

A total of 25,638 glinide, 272,140 sulfonylurea, and 29,376 acarbose initiators were included in the analysis. Patients who initiated glinide had the highest crude HHF incidence. In the analysis adjusted for baseline differences, a significantly higher risk of HHF was found for glinide (adjusted HR, 1.53; 95% CI, 1.24-1.88), but not for sulfonylurea (adjusted HR, 0.94; 95% CI, 0.80-1.11), as compared with acarbose. The elevated risk remained consistent across different subgroups of patients as well as several sensitivity analyses including exploring the impact of potential unmeasured confounding.

CONCLUSIONS

These findings indicated that, as compared with acarbose, glinide may be associated with a higher risk of HHF for type 2 diabetic patients. Further researchis needed to fully evaluate the risks and benefits of glinide therapy relative to other oral anti-diabetic agents.

Authors+Show Affiliations

Department of Family Medicine, Cathay General Hospital, Taipei, Taiwan.Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. Electronic address: chiahsuin123@yahoo.com.tw.Faculty of Pharmacy, School of Pharmaceutical Science, National Yang-Ming University.Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.Institute of Statistical Science, Academia Sinica, Taiwan.Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

27923207

Citation

Lee, Yen-Chieh, et al. "Comparing the Risks of Hospitalized Heart Failure Associated With Glinide, Sulfonylurea, and Acarbose Use in Type 2 Diabetes: a Nationwide Study." International Journal of Cardiology, vol. 228, 2017, pp. 1007-1014.
Lee YC, Chang CH, Dong YH, et al. Comparing the risks of hospitalized heart failure associated with glinide, sulfonylurea, and acarbose use in type 2 diabetes: A nationwide study. Int J Cardiol. 2017;228:1007-1014.
Lee, Y. C., Chang, C. H., Dong, Y. H., Lin, J. W., Wu, L. C., Hwang, J. S., & Chuang, L. M. (2017). Comparing the risks of hospitalized heart failure associated with glinide, sulfonylurea, and acarbose use in type 2 diabetes: A nationwide study. International Journal of Cardiology, 228, 1007-1014. https://doi.org/10.1016/j.ijcard.2016.11.022
Lee YC, et al. Comparing the Risks of Hospitalized Heart Failure Associated With Glinide, Sulfonylurea, and Acarbose Use in Type 2 Diabetes: a Nationwide Study. Int J Cardiol. 2017 Feb 1;228:1007-1014. PubMed PMID: 27923207.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparing the risks of hospitalized heart failure associated with glinide, sulfonylurea, and acarbose use in type 2 diabetes: A nationwide study. AU - Lee,Yen-Chieh, AU - Chang,Chia-Hsuin, AU - Dong,Yaa-Hui, AU - Lin,Jou-Wei, AU - Wu,Li-Chiu, AU - Hwang,Jing-Shiang, AU - Chuang,Lee-Ming, Y1 - 2016/11/10/ PY - 2016/07/13/received PY - 2016/11/01/revised PY - 2016/11/04/accepted PY - 2016/12/7/pubmed PY - 2017/11/3/medline PY - 2016/12/7/entrez KW - Acarbose KW - Glinides KW - Heart failure KW - Sulfonylurea SP - 1007 EP - 1014 JF - International journal of cardiology JO - Int J Cardiol VL - 228 N2 - BACKGROUND: Increasing evidence suggests that certain newer anti-diabetic drugs are associated with an increased risk of hospitalized heart failure (HHF). However, the potential risks associated with the use of sulfonylurea and glinide have not been carefully evaluated. METHODS: A retrospective cohort study using the Taiwan National Health Insurance claims database was conducted to examine the risks of HHF among newly diagnosed type 2 diabetic patients who initiated glinide, sulfonylurea, or acarbose therapy during 2006-2012. The outcome of interest was hospitalization due to heart failure after treatment initiation, defined by ICD-9-CM code. A Cox proportional hazard regression model was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) using acarbose as the reference group. RESULTS: A total of 25,638 glinide, 272,140 sulfonylurea, and 29,376 acarbose initiators were included in the analysis. Patients who initiated glinide had the highest crude HHF incidence. In the analysis adjusted for baseline differences, a significantly higher risk of HHF was found for glinide (adjusted HR, 1.53; 95% CI, 1.24-1.88), but not for sulfonylurea (adjusted HR, 0.94; 95% CI, 0.80-1.11), as compared with acarbose. The elevated risk remained consistent across different subgroups of patients as well as several sensitivity analyses including exploring the impact of potential unmeasured confounding. CONCLUSIONS: These findings indicated that, as compared with acarbose, glinide may be associated with a higher risk of HHF for type 2 diabetic patients. Further researchis needed to fully evaluate the risks and benefits of glinide therapy relative to other oral anti-diabetic agents. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/27923207/Comparing_the_risks_of_hospitalized_heart_failure_associated_with_glinide_sulfonylurea_and_acarbose_use_in_type_2_diabetes:_A_nationwide_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(16)33459-3 DB - PRIME DP - Unbound Medicine ER -