Effects on All-cause Mortality and Cardiovascular Outcomes in Patients With Type 2 Diabetes by Comparing Insulin With Oral Hypoglycemic Agent Therapy: A Meta-analysis of Randomized Controlled Trials

Clinical Therapeutics
Juan LiNanwei Tong

Abstract

Retrospective, case-control studies and prospective randomized controlled trials (RCTs) on insulin treatment for diabetic patients yielded contradictory mortality and cardiovascular outcomes. We aimed to evaluate the effects of insulin versus oral hypoglycemic agents (OHAs) on all-cause mortality and cardiovascular outcomes in patients with type 2 diabetes (T2D). We searched Medline, Embase, Cochrane Central Register of Controlled Trials, Chinese Biological Medicine Database, China National Knowledge Infrastructure, Chinese Technical Periodicals, and Wanfang Data, up to July 10, 2015, for RCTs on insulin and OHAs that assessed all-cause mortality and/or cardiovascular death as primary end points. We derived pooled risk ratios (RRs) as summary statistics. Three trials were included in which 7649 patients received insulin and 8322 received OHAs, with mean (SD) diabetes duration of 5.0 (6.2) and 4.4 (5.9) years, respectively. Insulin did not differ from OHAs in all-cause mortality (RR = 1.00; 95% CI, 0.93-1.07), cardiovascular death (RR = 1.00; 95% CI, 0.91-1.09), myocardial infarction (RR = 1.04; 95% CI, 0.93-1.16), angina (RR = 0.97; 95% CI, 0.88-1.06), sudden death (RR = 1.02; 95% CI, 0.66-1.56), or stroke (RR = 1.01; 95% CI, 0...Continue Reading

References

Jan 31, 2003·The New England Journal of Medicine·Peter GaedeOluf Pedersen
Apr 12, 2006·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Rajesh HiralalHertzel C Gerstein
Jun 10, 2008·The New England Journal of Medicine·Anushka PatelFlorence Travert
Dec 19, 2008·The New England Journal of Medicine·William DuckworthUNKNOWN VADT Investigators
Mar 10, 2009·Diabetes, Obesity & Metabolism·A-M AasUNKNOWN DIGAMI 2 Investigators
Oct 1, 2009·Diabetes, Obesity & Metabolism·J-M GambleJ A Johnson
Nov 13, 2009·Diabetes Care·Simon R Heller, UNKNOWN ADVANCE Collaborative Group
Feb 2, 2010·European Heart Journal·Michel KomajdaPhilip D Home
Mar 20, 2010·The Journal of Clinical Endocrinology and Metabolism·Bernard CharbonnelUNKNOWN PROactive investigators
Oct 13, 2010·Diabetes Care·Danielle C ColaycoT Craig Cheetham
Sep 15, 2011·Diabetic Medicine : a Journal of the British Diabetic Association·D R WebbUNKNOWN ADDITION-Leicester study group
Jan 11, 2013·Kidney International·Vlado PerkovicUNKNOWN ADVANCE Collaborative Group
Feb 2, 2013·The Journal of Clinical Endocrinology and Metabolism·Craig J CurrieChristopher Ll Morgan
Nov 2, 2013·Clinical Journal of the American Society of Nephrology : CJASN·Phyllis AugustUNKNOWN BARI 2D Study Group
Feb 19, 2014·Diabetes, Obesity & Metabolism·S E Holden, C J Currie

❮ Previous
Next ❯

Citations

Jul 3, 2019·Current Vascular Pharmacology·Dimitrios PatouliasAsterios Karagiannis
Jun 13, 2017·The New England Journal of Medicine·Steven P MarsoUNKNOWN DEVOTE Study Group
Feb 6, 2020·Current Vascular Pharmacology·Dimitrios PatouliasAsterios Karagiannis

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiovascular Disorder in Diabetes

Diabetes is associated with an increased risk of cardiovascular disorders and heart failure. Discover the latest research here.

CV Disorders & Type 2 Diabetes

This feed focuses on the association of cardiovascular diseases in patients with type 2 diabetes.