Document Detail

Association between oral antidiabetic use, adverse events and outcomes in patients with type 2 diabetes.
MedLine Citation:
PMID:  17645555     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To quantify adverse events (AEs) associated with the use of metformin (MET), sulphonylureas (SUs) and thiazolidinediones (TZDs) in a usual care setting, and to assess the relationship of AEs to treatment patterns and glycaemic response in patients with type 2 diabetes.
RESEARCH DESIGN AND METHODS: An electronic medical record database was used to identify patients with type 2 diabetes age >or=18 years from 1996 to 2005. Patients naïve to oral antidiabetic therapy were followed for 395 days postinitiation of MET, SU or TZD treatment. AEs related to study drugs were evaluated during the follow-up period. Baseline and follow-up A1C levels were compared by drug regimen. Associations between the change in A1C, drug regimen changes and AEs were evaluated.
RESULTS: A total of 14,512 patients (mean age 60.8 years, 52.9% female) were identified. During the follow-up period, 12.7% of patients experienced an AE (8.6% MET, 15.9% SU and 19.8% TZD patients). SU and TZD patients were more likely to experience an AE than MET (p < 0.001) patients. AEs did not significantly influence A1C outcomes, although MET and SU patients experiencing an AE were more likely to add-on therapy (odds ratio (OR) = 1.34 and OR = 1.37, respectively; p < 0.05) than those without an AE. MET patients with AEs were more likely to switch therapy (OR = 1.91; p < 0.05) than those without an AE.
CONCLUSIONS: The occurrence of AEs did not significantly impact glycaemic response to therapy. However, AEs may lead to greater treatment switches for patients receiving MET and add-on therapy for MET-treated and SU-treated patients.
C V Asche; C McAdam-Marx; L Shane-McWhorter; X Sheng; C A Plauschinat
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-07-21
Journal Detail:
Title:  Diabetes, obesity & metabolism     Volume:  10     ISSN:  1463-1326     ISO Abbreviation:  Diabetes Obes Metab     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-18     Completed Date:  2009-02-20     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  100883645     Medline TA:  Diabetes Obes Metab     Country:  England    
Other Details:
Languages:  eng     Pagination:  638-45     Citation Subset:  IM    
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MeSH Terms
Administration, Oral
Diabetes Mellitus, Type 2 / drug therapy*
Hemoglobin A, Glycosylated / drug effects,  metabolism*
Hypoglycemic Agents / administration & dosage*,  adverse effects
Metformin / administration & dosage*,  adverse effects
Middle Aged
Sulfonylurea Compounds / administration & dosage*,  adverse effects
Thiazolidinediones / administration & dosage*,  adverse effects
Treatment Outcome
Young Adult
Reg. No./Substance:
0/Hemoglobin A, Glycosylated; 0/Hypoglycemic Agents; 0/Sulfonylurea Compounds; 0/Thiazolidinediones; 9100L32L2N/Metformin

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