Impact of differing glucose‐lowering regimens on the pattern of association between glucose control and survival

Aims To characterize survival in relation to achieved glycated haemoglobin (HbA1c) level within alternative glucose‐lowering regimens with differing risks of hypoglycaemia. Methods Data were extracted from the UK Clinical Practice Research Datalink and the corresponding Hospital Episode Statistics....

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Bibliographic Details
Published in:Diabetes, obesity & metabolism obesity & metabolism, 2018-04, Vol.20 (4), p.821-830
Main Authors: Currie, Craig J., Holden, Sarah E., Jenkins‐Jones, Sara, Morgan, Christopher Ll, Voss, Bernd, Rajpathak, Swapnil N., Alemayehu, Berhanu, Peters, John R., Engel, Samuel S.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Blood Glucose - drug effects
Blood Glucose - metabolism
Cardiovascular Diseases - etiology
Cardiovascular Diseases - mortality
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - drug therapy
Diabetes Mellitus, Type 2 - mortality
Diabetic Angiopathies - drug therapy
Diabetic Angiopathies - mortality
Female
Glucose
Hemoglobin
Humans
hypoglycaemia
Hypoglycemia
Hypoglycemic Agents - classification
Hypoglycemic Agents - therapeutic use
Insulin
Male
Metformin
Middle Aged
Mortality
Original
Retrospective Studies
Risk Factors
Statistical analysis
Survival
Survival Analysis
United Kingdom - epidemiology
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Summary:Aims To characterize survival in relation to achieved glycated haemoglobin (HbA1c) level within alternative glucose‐lowering regimens with differing risks of hypoglycaemia. Methods Data were extracted from the UK Clinical Practice Research Datalink and the corresponding Hospital Episode Statistics. Patients with type 2 diabetes prescribed glucose‐lowering therapy in monotherapy or dual therapy with metformin between 2004 and 2013 were identified. Risk of all‐cause mortality within treatment cohorts was evaluated using the Cox proportional hazards model, introducing mean HbA1c as a quarterly updated, time‐dependent covariable. Results There were 6646 deaths in a total follow‐up period of 374 591 years. Survival for lower (
ISSN:1462-8902
1463-1326
DOI:10.1111/dom.13155