PMID- 33655987
OWN - NLM
STAT- MEDLINE
DCOM- 20210309
LR  - 20240331
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 100
IP  - 9
DP  - 2021 Mar 5
TI  - Impacts of early insulin treatment vs glimepiride in diabetic patients with 
      background metformin therapy: A nationwide retrospective cohort study.
PG  - e25085
LID - 10.1097/MD.0000000000025085 [doi]
LID - e25085
AB  - Type 2 diabetes mellitus (T2DM) is a progressive disease. After metformin 
      failure, the addition of insulin or sulfonylureas might increase the risk of 
      hypoglycemia and cardiovascular (CV) morbidity. Here, the risk of all-cause 
      mortality was compared between early insulin treatment and glimepiride use in 
      T2DM patients with background metformin therapy.We conducted a 9-year 
      retrospective cohort study from the population-based National Health Insurance 
      Research Database in Taiwan. A total of 2054 patients with T2DM under insulin or 
      glimepiride treatment were enrolled during 2004 to 2012. Overall event rates of 
      all-cause mortality were compared between 1027 insulin users and 1027 matched 
      glimepiride users.After the propensity score matching, the mortality rates were 
      72.5 and 4.42 per 1000 person-years for insulin users and glimepiride users. The 
      adjusted hazard ratio of mortality was 14.47 (95% CI: 8.64-24.24; P value <.001) 
      as insulin compared with glimepiride users. The insulin users had significantly 
      higher risk of CV death (adjusted hazard ratio 7.95, 95% CI 1.65-38.3, P = .01) 
      and noncardiovascular death (adjusted hazard ratio 14.9, 95% CI 8.4-26.3, 
      P < .001).The nationwide study demonstrated that metformin plus insulin therapy 
      was associated with higher risk of all-cause mortality.
CI  - Copyright (c) 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Yen, Fu-Shun
AU  - Yen FS
AD  - Dr. Yen's Clinic, No. 15, Shanying Road, Gueishan District, Taoyuan.
FAU - Hsu, Chih-Cheng
AU  - Hsu CC
AD  - Institute of Population Health Sciences, National Health Research Institutes, 
      Zhunan.
AD  - Department of Health Services Administration, China Medical University, Taichung.
AD  - Department of Family Medicine, Min-Sheng General Hospital, Taoyuan.
FAU - Su, Yuan-Chih
AU  - Su YC
AD  - Management Office for Health Data, China Medical University Hospital.
AD  - College of Medicine, China Medical University, Taichung.
FAU - Wei, James Cheng-Chung
AU  - Wei JC
AD  - Institute of Medicine, Chung Shan Medical University.
AD  - Department of Medicine, Chung Shan Medical University Hospital.
AD  - Graduate Institute of Integrated Medicine, China Medical University, Taichung.
FAU - Hwu, Chii-Min
AU  - Hwu CM
AUID- ORCID: 0000-0002-8209-9627
AD  - Department of Medicine, National Yang-Ming University School of Medicine.
AD  - Section of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans 
      General Hospital, Taipei, Taiwan.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (Sulfonylurea Compounds)
RN  - 6KY687524K (glimepiride)
RN  - 9100L32L2N (Metformin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cause of Death/trends
MH  - Diabetes Mellitus, Type 2/*drug therapy/mortality
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Hypoglycemic Agents/therapeutic use
MH  - Insulin/*therapeutic use
MH  - Male
MH  - Metformin/*therapeutic use
MH  - Middle Aged
MH  - Population Surveillance/*methods
MH  - Retrospective Studies
MH  - Sulfonylurea Compounds/*therapeutic use
MH  - Taiwan/epidemiology
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC7939219
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2021/03/04 06:00
MHDA- 2021/03/10 06:00
PMCR- 2021/03/05
CRDT- 2021/03/03 08:53
PHST- 2020/11/24 00:00 [received]
PHST- 2021/02/17 00:00 [accepted]
PHST- 2021/03/03 08:53 [entrez]
PHST- 2021/03/04 06:00 [pubmed]
PHST- 2021/03/10 06:00 [medline]
PHST- 2021/03/05 00:00 [pmc-release]
AID - 00005792-202103050-00084 [pii]
AID - MD-D-20-11507 [pii]
AID - 10.1097/MD.0000000000025085 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2021 Mar 5;100(9):e25085. doi: 10.1097/MD.0000000000025085.