Comparative Effectiveness of Insulin versus Combination Sulfonylurea and Insulin: a Cohort Study of Veterans with Type 2 Diabetes

ABSTRACT BACKGROUND Type 2 diabetes patients often initiate treatment with a sulfonylurea and subsequently intensify their therapy with insulin. However, information on optimal treatment regimens for these patients is limited. OBJECTIVE To compare risk of cardiovascular disease (CVD) and hypoglycemi...

Full description

Saved in:
Bibliographic Details
Published in:Journal of general internal medicine : JGIM 2016-06, Vol.31 (6), p.638-646
Main Authors: Min, Jea Young, Griffin, Marie R., Hung, Adriana M., Grijalva, Carlos G., Greevy, Robert A., Liu, Xulei, Elasy, Tom, Roumie, Christianne L.
Format: Article
Language:English
Subjects:
Adult
Aged
Blood glucose
Cardiovascular diseases
Cardiovascular Diseases - chemically induced
Cardiovascular Diseases - epidemiology
Cerebral infarction
Cohort analysis
Cohort Studies
Comparative Effectiveness Research - methods
Confidence intervals
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - drug therapy
Diabetes Mellitus, Type 2 - epidemiology
Disease control
Drug Substitution
Drug Therapy, Combination
Emergency medical services
Female
Glomerular filtration rate
Government programs
Health care
Health risks
Humans
Hypoglycemia
Hypoglycemia - chemically induced
Hypoglycemia - epidemiology
Hypoglycemic Agents - adverse effects
Hypoglycemic Agents - therapeutic use
Initiators
Insulin
Insulin - adverse effects
Insulin - therapeutic use
Internal Medicine
Male
Mathematical models
Medicine
Medicine & Public Health
Middle Aged
Myocardial infarction
Original Research
Patients
Retrospective Studies
Statistical analysis
Stroke
Subgroups
Sulfonylurea
Sulfonylurea Compounds - adverse effects
Sulfonylurea Compounds - therapeutic use
United States - epidemiology
Veterans
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:ABSTRACT BACKGROUND Type 2 diabetes patients often initiate treatment with a sulfonylurea and subsequently intensify their therapy with insulin. However, information on optimal treatment regimens for these patients is limited. OBJECTIVE To compare risk of cardiovascular disease (CVD) and hypoglycemia between sulfonylurea initiators who switch to or add insulin. DESIGN This was a retrospective cohort assembled using national Veterans Health Administration (VHA), Medicare, and National Death Index databases. PARTICIPANTS Veterans who initiated diabetes treatment with a sulfonylurea between 2001 and 2008 and intensified their regimen with insulin were followed through 2011. MAIN MEASURES The association between insulin versus sulfonylurea + insulin and time to CVD or hypoglycemia were evaluated using Cox proportional hazard models in a 1:1 propensity score-matched cohort. CVD included hospitalization for acute myocardial infarction or stroke, or cardiovascular mortality. Hypoglycemia included hospitalizations or emergency visits for hypoglycemia, or outpatient blood glucose measurements
ISSN:0884-8734
1525-1497
DOI:10.1007/s11606-016-3633-2