Long-term outcomes of adding alpha-glucosidase inhibitors in insulin-treated patients with type 2 diabetes
Open Access
- 18 February 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Endocrine Disorders
- Vol. 21 (1), 1-10
- https://doi.org/10.1186/s12902-021-00690-0
Abstract
In insulin-treated patients with type 2 diabetes mellitus (T2DM), glycemic control is usually suboptimal. This study compared the risks of mortality and cardiovascular events in insulin-treated patients adding or not adding alpha-glucosidase inhibitors (AGIs). This cohort study included data from the Taiwan National Health Insurance Research Database. In total, 17,417 patients newly diagnosed as having T2DM and undergoing insulin therapy during 2000–2012 were enrolled. Overall incidence rates of all-cause mortality, hospitalized coronary artery disease (CAD), stroke, and heart failure were compared between 4165 AGI users and 4165 matched nonusers. The incidence rates of all-cause mortality were 17.10 and 19.61 per 1000 person-years in AGI nonusers and users, respectively. Compared with nonusers, AGI users had a higher mortality risk [adjusted hazard ratio (aHR) = 1.21, 95% confidence interval (CI) = 1.05–1.40; p = 0.01]. Regarding AGI use, aHRs (95% CI) for cardiovascular death, non-cardiovascular death, hospitalized CAD, stroke, and heart failure were 1.20 (0.83–1.74), 1.27 (1.07–1.50), 1.12 (0.95–1.31), 0.98 (0.85–1.14), and 1.03 (0.87–1.22) respectively. AGI use was associated with higher risks of all-cause mortality and non-cardiovascular death in insulin-treated patients with T2DM. Therefore, adding AGIs in insulin-treated patients may not be appropriate.Keywords
This publication has 29 references indexed in Scilit:
- Trends of mortality in diabetic patients in Taiwan: A nationwide survey in 2005–2014Journal of the Formosan Medical Association, 2019
- Effects of acarbose on cardiovascular and diabetes outcomes in patients with coronary heart disease and impaired glucose tolerance (ACE): a randomised, double-blind, placebo-controlled trialThe Lancet Diabetes & Endocrinology, 2017
- Cardiovascular risks associated with second‐line oral antidiabetic agents added to metformin in patients with Type 2 diabetes: a nationwide cohort studyDiabetic Medicine, 2015
- On the potential of acarbose to reduce cardiovascular diseaseCardiovascular Diabetology, 2014
- Validating the adapted Diabetes Complications Severity Index in claims data.2012
- Diabetes Mellitus, Fasting Glucose, and Risk of Cause-Specific DeathThe New England Journal of Medicine, 2011
- Insulin use and increased risk of mortality in type 2 diabetes: a cohort studyDiabetes, Obesity and Metabolism, 2009
- Acarbose Treatment and the Risk of Cardiovascular Disease and Hypertension in Patients With Impaired Glucose ToleranceJAMA, 2003
- Comparing hospital discharge records with death certificates: Can the differences be explained?Journal of Epidemiology and Community Health, 2002
- Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control groupStatistics in Medicine, 1998