PMID- 22801248
OWN - NLM
STAT- MEDLINE
DCOM- 20130715
LR  - 20160804
IS  - 1708-8267 (Electronic)
IS  - 1081-5589 (Linking)
VI  - 60
IP  - 7
DP  - 2012 Oct
TI  - Different antidiabetic regimens and the development of renal dysfunction in US 
      Veterans with type 2 diabetes mellitus.
PG  - 1009-14
LID - 10.2310/JIM.0b013e3182621dbf [doi]
AB  - AIM: The aim of this study was to evaluate the development of renal dysfunction 
      in veterans with type 2 diabetes mellitus (T2DM) treated with different 
      antidiabetic regimens. METHODS: A retrospective cohort study involving 1715 
      patients with T2DM and baseline serum creatinine (SCr) of 1.5 mg/dL or lesser. 
      The development of renal dysfunction, defined as 0.5 mg/dL or greater increase 
      from baseline SCr during 4.8 years of follow-up with monotherapy metformin (M), 2 
      combination therapy groups: metformin + insulin (MI) and metformin + sulfonylurea 
      (MS) users were compared with changes observed in sulfonylurea monotherapy users 
      (S). RESULTS: Both MI and MS groups had higher mean baseline hemoglobin A1C 
      (HbA1C) (9.0 and 8.6%, respectively) and higher rates of baseline 
      macroalbuminuria (17.3 and 12.1%, respectively) as compared with M and S groups 
      (mean HbA1C7.7% in both groups, and proteinuria M-5.1% and S-7.4%). In unadjusted 
      analysis, the development of renal dysfunction was more frequent in MI and MS but 
      not in M group as compared with sulfonylurea monotherapy (unadjusted HRs and [95% 
      confidence interval (CI), 2.1[1.4-3.0], 1.4[1.1-1.9], and 1.0[0.6-1.7], 
      respectively). However, differences in the development of renal dysfunction were 
      not significant between the 4 groups after adjusting for baseline variables. 
      Baseline macroalbuminuria was a strong predictor of Scr elevation of 0.5 mg/dL or 
      greater during follow-up (adjusted HR, 3.1[1.9-4.7]). Unexpectedly, baseline use 
      of renin-angiotensin-aldosterone system blockers was also associated with the 
      development of renal dysfunction (adjusted HR, 1.9[1.3-2.8]). CONCLUSIONS: In 
      this retrospective cohort study involving US predominantly male veterans with 
      T2DM, baseline macroalbuminuria and use of RAAS blockers were associated with 
      increased risk of development of renal dysfunction, whereas different 
      antidiabetic regimens were not.
FAU - Gosmanova, Elvira O
AU  - Gosmanova EO
AD  - Division of Nephrology, Department of Medicine, University of Tennessee Health 
      Science Center, Memphis, TN 38103, USA. egosmano@uthsc.edu
FAU - Canada, Robert B
AU  - Canada RB
FAU - Wan, Jim
AU  - Wan J
FAU - Mangold, Therese A
AU  - Mangold TA
FAU - Wall, Barry M
AU  - Wall BM
LA  - eng
PT  - Journal Article
PL  - England
TA  - J Investig Med
JT  - Journal of investigative medicine : the official publication of the American 
      Federation for Clinical Research
JID - 9501229
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (Sulfonylurea Compounds)
RN  - 9100L32L2N (Metformin)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Albuminuria/complications/physiopathology
MH  - Creatinine/blood
MH  - Demography
MH  - Diabetes Mellitus, Type 2/blood/complications/*drug therapy/*physiopathology
MH  - Female
MH  - Humans
MH  - Hypoglycemic Agents/pharmacology/*therapeutic use
MH  - Insulin/pharmacology/therapeutic use
MH  - Kidney/drug effects/*physiopathology
MH  - Male
MH  - Metformin/pharmacology/therapeutic use
MH  - Middle Aged
MH  - Odds Ratio
MH  - Renin-Angiotensin System/drug effects
MH  - Sulfonylurea Compounds/pharmacology/therapeutic use
MH  - *Veterans
EDAT- 2012/07/18 06:00
MHDA- 2013/07/17 06:00
CRDT- 2012/07/18 06:00
PHST- 2012/07/18 06:00 [entrez]
PHST- 2012/07/18 06:00 [pubmed]
PHST- 2013/07/17 06:00 [medline]
AID - 10.2310/JIM.0b013e3182621dbf [doi]
PST - ppublish
SO  - J Investig Med. 2012 Oct;60(7):1009-14. doi: 10.2310/JIM.0b013e3182621dbf.