PMID- 31544207
OWN - NLM
STAT- MEDLINE
DCOM- 20201109
LR  - 20201109
IS  - 1945-7197 (Electronic)
IS  - 0021-972X (Linking)
VI  - 105
IP  - 3
DP  - 2020 Mar 1
TI  - Pioglitazone Exposure Reduced the Risk of All-Cause Mortality in Insulin-Treated 
      Patients with Type 2 Diabetes Mellitus.
LID - dgz026 [pii]
LID - 10.1210/clinem/dgz026 [doi]
AB  - CONTEXT: The long-term safety and benefit of pioglitazone use in combination with 
      insulin are still uncertain. OBJECTIVE: This study compared the risks of 
      all-cause mortality and major cardiovascular (CV) events between pioglitazone 
      users and nonusers receiving insulin therapy. DESIGN, SETTING AND PATIENTS: We 
      conducted a 13-year retrospective cohort study by using data from the 
      population-based National Health Insurance Research Database in Taiwan. A total 
      of 20 376 patients with type 2 diabetes mellitus (T2DM) receiving insulin therapy 
      were enrolled during 2000 to 2012. Overall, the incidence rates of all-cause 
      mortality and CV events were compared between 2579 pioglitazone users and 2579 
      matched nonusers. RESULTS: After adjustment for age, sex, comorbidities, Diabetes 
      Complications Severity Index scores, and drugs used, mortality rates were 30.26 
      and 15.02 per 1000 person-years for pioglitazone nonusers and users, 
      respectively. The adjusted hazard ratio (aHR) of mortality was 0.47 (95% 
      confidence interval [CI]: 0.38-0.58, P < 0.001) for pioglitazone users compared 
      with nonusers. The aHRs of CV and non-CV deaths were 0.78 (95% CI: 0.51-1.19) and 
      0.50 (95% CI: 0.38-0.66), respectively. The aHRs of hospitalized coronary artery 
      disease, hospitalized stroke, and incident heart failure were not significantly 
      different between pioglitazone users and nonusers. CONCLUSIONS: This nationwide 
      cohort study demonstrated that pioglitazone use reduced the risks of all-cause 
      mortality and non-CV death for patients with T2DM undergoing insulin therapy.
CI  - (c) Endocrine Society 2019. All rights reserved. For permissions, please e-mail: 
      journals.permissions@oup.com.
FAU - Yen, Fu-Shun
AU  - Yen FS
AD  - Dr. Yen's Clinic, Taoyuan, Taiwan.
FAU - Wang, Hsiang-Chi
AU  - Wang HC
AD  - Management Office for Health Data, China Medical University Hospital, Taichung, 
      Taiwan.
AD  - College of Medicine, China Medical University, Taichung, Taiwan.
FAU - Pan, Chun-Wei
AU  - Pan CW
AD  - University of the East Ramon Magsaysay Memorial Medical Centre, Inc., Quezon, 
      Philippines.
FAU - Wei, James Cheng-Chung
AU  - Wei JC
AD  - Division of Allergy, Immunology and Rheumatology Chung Shan Medical University 
      Hospital, Taichung, Taiwan.
FAU - Hsu, Chih-Cheng
AU  - Hsu CC
AD  - Institute of Population Health Sciences, National Health Research Institutes, 
      Zhunan, Taiwan.
AD  - Department of Health Services Administration, China Medical University, Taichung, 
      Taiwan.
AD  - Department of Family Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan.
FAU - Hwu, Chii-Min
AU  - Hwu CM
AD  - Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, 
      Taiwan.
AD  - Section of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans 
      General Hospital, Taipei, Taiwan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
RN  - 0 (Biomarkers)
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - X4OV71U42S (Pioglitazone)
SB  - IM
MH  - Aged
MH  - Biomarkers/*analysis
MH  - Blood Glucose/analysis
MH  - Diabetes Mellitus, Type 2/drug therapy/epidemiology/*mortality/pathology
MH  - Drug Therapy, Combination
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Insulin/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Pioglitazone/*therapeutic use
MH  - Prognosis
MH  - Retrospective Studies
MH  - Survival Rate
MH  - Taiwan/epidemiology
OTO - NOTNLM
OT  - insulin
OT  - mortality
OT  - pioglitazone
OT  - therapeutics
OT  - type 2 diabetes mellitus
EDAT- 2019/09/24 06:00
MHDA- 2020/11/11 06:00
CRDT- 2019/09/24 06:00
PHST- 2019/06/21 00:00 [received]
PHST- 2019/08/01 00:00 [revised]
PHST- 2019/09/24 06:00 [pubmed]
PHST- 2020/11/11 06:00 [medline]
PHST- 2019/09/24 06:00 [entrez]
AID - 5572576 [pii]
AID - 10.1210/clinem/dgz026 [doi]
PST - ppublish
SO  - J Clin Endocrinol Metab. 2020 Mar 1;105(3):dgz026. doi: 10.1210/clinem/dgz026.