Sulfonylureas as second line drugs in type 2 diabetes and the risk of cardiovascular and hypoglycaemic events: population based cohort study

BMJ : British Medical Journal
Antonios DourosSamy Suissa

Abstract

To assess whether adding or switching to sulfonylureas is associated with an increased risk of myocardial infarction, ischaemic stroke, cardiovascular death, all cause mortality, and severe hypoglycaemia, compared with remaining on metformin monotherapy in patients with type 2 diabetes. Population based cohort study. General practices contributing data to the UK Clinical Practice Research Datalink. Patients with type 2 diabetes initiating metformin monotherapy between 1998 and 2013. Using the prevalent new-user cohort design we matched 1:1 patients adding or switching to sulfonylureas with those remaining on metformin monotherapy on high-dimensional propensity score, haemoglobin A1c, and number of previous metformin prescriptions. The two groups were compared using Cox proportional hazards models to estimate adjusted hazard ratios and 95% confidence intervals for the study outcomes. Among 77 138 metformin initiators, 25 699 added or switched to sulfonylureas during the study period. During a mean follow-up of 1.1 years, sulfonylureas were associated with an increased risk of myocardial infarction (incidence rate 7.8 v 6.2 per 1000 person years, hazard ratio 1.26, 95% confidence interval 1.01 to 1.56), all cause mortality (27.3 ...Continue Reading

Citations

Aug 7, 2019·Journal of Hypertension·Shiu Lun Au YeungCatherine M Schooling
Jul 18, 2019·Journal of General and Family Medicine·Masayuki Ikeda, Rumiko Shimazawa
Aug 7, 2019·Cardiovascular Diabetology·Aaron Y KlugerPeter A McCullough
Aug 18, 2020·Cardiovascular Endocrinology & Metabolism·Dennis Bruemmer, Steven E Nissen
Aug 22, 2020·Journal of Lipid and Atherosclerosis·Laura J MereweatherLisa C Heather
Jan 28, 2021·Diabetes, Obesity & Metabolism·So-Hee ParkJu-Young Shin
Nov 26, 2020·Journal of Clinical Medicine·Jordan GuillotJulien Bezin
Jun 4, 2021·Current Cardiology Reports·Ben Alencherry, Dennis Bruemmer
Jul 13, 2021·Diabetes, Obesity & Metabolism·Karine SuissaLaurent Azoulay
Aug 27, 2021·Frontiers in Nutrition·Mark CucuzzellaDiana Isaacs

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