Metformin Treatment Is Associated with a Decreased Risk of Nonproliferative Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus: A Population-Based Cohort Study

Purpose. To assess the relationship between metformin use and the severity of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM) and to investigate the effect of metformin dosage on reducing the incidence of DR. Methods. The study population included patients with newly diagn...

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Bibliographic Details
Published in:Journal of diabetes research 2020, Vol.2020 (2020), p.1-12
Main Authors: Yang, Chen-Chang, Liu, Hsiao Yu, Hsiung, Chao A., Lin, Jiun-Lu, Wu, Chien-Tung, Fan, Yu-Pei, Lai, Jung-Nien
Format: Article
Language:English
Subjects:
Adult
Age
Aged
Antidiabetics
Antihypertensives
Cohort analysis
Cohort Studies
Comorbidity
Diabetes
Diabetes Mellitus, Type 2 - drug therapy
Diabetic retinopathy
Diabetic Retinopathy - diagnosis
Diabetic Retinopathy - epidemiology
Disease
Disease Progression
Drug dosages
Edema
Female
Health insurance
Humans
Hypoglycemic Agents - therapeutic use
Incidence
Male
Metformin - therapeutic use
Middle Aged
Patients
Population
Population-based studies
Prescription drugs
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Summary:Purpose. To assess the relationship between metformin use and the severity of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM) and to investigate the effect of metformin dosage on reducing the incidence of DR. Methods. The study population included patients with newly diagnosed T2DM, who were aged ≥20 years and prescribed with antidiabetic drug therapy lasting ≥90 days, as identified using the National Health Insurance Research Database between 2000 and 2012. We matched metformin users and nonusers by a propensity score. Cox proportional hazard regression analyses were used to compute and compare the risk of developing nonproliferative diabetic retinopathy (NPDR) in metformin users and nonusers. Results. Overall, 10,044 T2DM patients were enrolled. Metformin treatment was associated with a lower risk of NPDR (aHR 0.76, 95% CI 0.68–0.87) and sight-threatening diabetic retinopathy (STDR, aHR 0.29, 95% CI 0.19–0.45); however, the reduction in risk was borderline significant for STDR progression among NPDR patients (aHR 0.54, 95% CI 0.28–1.01). Combination therapy of metformin and DPP-4i exhibited a stronger but inverse relationship with NPDR development (aHR 0.32, 95% CI 0.25–0.41), especially at early (
ISSN:2314-6745
2314-6753
DOI:10.1155/2020/9161039