1. Progression to insulin therapy among patients with type 2 diabetes treated with sitagliptin or sulphonylurea plus metformin dual therapy.
- Author
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Inzucchi, S. E., Tunceli, K., Qiu, Y., Rajpathak, S., Brodovicz, K. G., Engel, S. S., Mavros, P., Radican, L., Brudi, P., Li, Z., Fan, C. P. S., Hanna, B., Tang, J., and Blonde, L.
- Subjects
INSULIN therapy ,TYPE 2 diabetes treatment ,SITAGLIPTIN ,SULFONYLUREAS ,METFORMIN ,KAPLAN-Meier estimator ,LOGISTIC regression analysis ,THERAPEUTICS - Abstract
Aim To assess time to insulin initiation among patients with type 2 diabetes mellitus ( T2DM) treated with sitagliptin versus sulphonylurea as add-on to metformin. Methods This retrospective cohort study used GE Centricity electronic medical records and included patients aged ≥18 years with continuous medical records and an initial prescription of sitagliptin or sulphonylurea (index date) with metformin for ≥90 days during 2006-2013. Sitagliptin and sulphonylurea users were matched 1 : 1 using propensity score matching, and differences in insulin initiation were assessed using Kaplan- Meier curves and Cox regression. We used conditional logistic regression to examine the likelihood of insulin use 1-6 years after the index date for each year. Results Propensity score matching produced 3864 matched pairs. Kaplan- Meier analysis showed that sitagliptin users had a lower risk of insulin initiation compared with sulphonylurea users (p = 0.003), with 26.6% of sitagliptin users initiating insulin versus 34.1% of sulphonylurea users over 6 years. This finding remained significant after adjusting for baseline characteristics (hazard ratio 0.76, 95% confidence interval 0.65-0.90). Conditional logistic regression analyses confirmed that sitagliptin users were less likely to initiate insulin compared with sulphonylurea users [odds ratios for years 1-6: 0.77, 0.79, 0.81, 0.57, 0.29 and 0.75, respectively (p < 0.05 for years 4 and 5)]. Conclusions In this real-world matched cohort study, patients with T2DM treated with sitagliptin had a significantly lower risk of insulin initiation compared with patients treated with sulphonylurea, both as add-on to metformin. [ABSTRACT FROM AUTHOR] more...
- Published
- 2015
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