Aim
To assess the impact of insulin glargine (100 U/mL) and lixisenatide (iGlarLixi) fixed‐ratio combination therapy on the overall management of glycaemia in patients with type 2 diabetes (T2D), ...previously inadequately controlled with oral antidiabetic drugs ± basal insulin or glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs).
Materials and Methods
This 12‐month, international, multicentre, prospective, observational study included patients (age ≥ 18 years) with T2D who had initiated iGlarLixi within 1 month prior to study inclusion. Data were collected at study inclusion, month 3, month 6 and month 12 from patient diaries, self‐measured plasma glucose, and questionnaires. The primary endpoint was change in HbA1c from baseline to month 6.
Results
Of the 737 eligible participants (mean age: 57.8 standard deviation: 11.2 years; male: 49%), 685 had baseline and post‐baseline HbA1c data available. The least squares mean change in HbA1c from baseline to month 6 was −1.4% (standard error 95% confidence interval (CI): 0.05 −1.5, −1.3). The absolute change from baseline at month 12 was −1.7% ± 1.9% (95% CI: −1.9, −1.5). There were 72 hypoglycaemia events reported during the study period, with a very low incidence of severe hypoglycaemia (two participants rate: 0.003 events per patient‐year).
Conclusions
This real‐world observational study shows that initiation of iGlarLixi in people with T2D inadequately controlled on oral antidiabetic drugs ± basal insulin or GLP‐1 RAs improves glycaemic control with a low incidence of hypoglycaemia.
Herpes zoster and postherpetic neuralgia cause substantial pain in patients. Persons with type 2 diabetes (T2D) are prone to zoster infection and postherpetic neuralgia due to compromised immunity. ...We conducted this study to evaluate the risks of herpes zoster and postherpetic neuralgia between metformin users and nonusers. Propensity score matching was utilized to select 47 472 pairs of metformin users and nonusers from Taiwan's National Health Insurance Research Database between January 1, 2000, and December 31, 2017. The Cox proportional hazards models were used for comparing the risks of herpes zoster and postherpetic neuralgia between metformin users and nonusers in patients with T2D. Compared with no‐use of metformin, the adjusted hazard ratios (95% confidence interval) for metformin use in herpes zoster and postherpetic neuralgia were 0.70 (0.66, 0.75) and 0.510 (0.39, 0.68), respectively. A higher cumulative dose of metformin had further lower risks of herpes zoster and postherpetic neuralgia than metformin no‐use. This nationwide cohort study demonstrated that metformin use was associated with a significantly lower risk of herpes zoster and postherpetic neuralgia than metformin no‐use. Moreover, a higher cumulative dose of metformin was associated with further lower risks of these outcomes.
Persons with type 2 diabetes (T2D) have neutrophil dysfunction with a higher risk of infection than those without diabetes. We conducted this study aiming to compare the risk of pneumonia between ...metformin use and nonuse in persons with T2D. We identified 49,012 propensity score-matched metformin users and nonusers from Taiwan's National Health Insurance Research Database between January 1, 2000, and December 31, 2017. We used the Cox proportional hazards model to compare the risks of pneumonia and respiratory death. The mean (SD) age of the participants was 57.46 (12.88) years, and the mean follow-up time for metformin users and nonusers was 5.47 (3.71) years and 5.15 (3.87) years, respectively. Compared with the nonuse of metformin, the adjusted hazard ratios (95% CI) for metformin use in bacterial pneumonia, invasive mechanical ventilation, and respiratory cause of death were 0.89 (0.84-0.94), 0.77 (0.73-0.82), and 0.64 (0.56-0.74), respectively. A longer cumulative duration of metformin use had further lower adjusted hazard ratios in these risks compared with nonuse. In patients with T2D, metformin use was associated with significantly lower risks of bacterial pneumonia, invasive mechanical ventilation, and respiratory cause of death; moreover, longer metformin use duration was associated with lower hazard ratios of these risks.
More rigorous studies are needed to obtain robust and consistent results to provide helpful and feasible dietary recommendations for patients with type 2 diabetes and nonalcoholic fatty liver disease
The natural history of youth‐onset type 2 diabetes between the West and the East seems similar, with a high proportion of comorbidities (obesity, hypertension and dyslipidemia), increased risk of ...microvascular complications and high treatment failure rates.
Aims/Introduction
The global incidence of adolescents with type 2 diabetes mellitus is increasing. This cohort study was conducted aiming to describe the characteristics, drug‐use condition, and ...long‐term outcomes of adolescents with type 2 diabetes mellitus.
Materials and Methods
Two thousand seven hundred fifty‐five newly diagnosed adolescents with type 2 diabetes mellitus (using ICD‐9‐CM: 250.x and having ≥3 clinic visits) were identified from the national health insurance dataset during 2000–2014. Treatments were classified into four groups: metformin, sulfonylurea (SU), metformin plus SU, and insulin with or without oral antidiabetic drugs. The multiple Cox regression model was used to compare the risks of mortality and hospitalization among these four groups.
Results
The mean follow‐up period was 5.4 years. After 1 year of antidiabetic treatment, they gradually needed intensified therapy, and at 3 years, half of them showed treatment failure. The mortality rate was 2.08 per 1,000 person‐years. Respiratory diseases (36.2%) and dysglycemia (16.4%) were the most common causes of hospitalization among these adolescents. Compared with persons taking metformin plus SU, metformin users were associated with a lower risk of all‐cause hospitalization 0.82 (0.67–0.99); insulin users were associated with a higher risk of dysglycemia 4.38 (2.14–8.96), cancer 3.76 (1.39–10.1), and respiratory hospitalization 1.66 (1.14–2.41); and SU users were associated with a higher risk of hospitalization for respiratory diseases 1.91 (1.13–3.23).
Conclusions
This nationwide cohort study demonstrated that adolescents with type 2 diabetes mellitus were prone to treatment failure. Furthermore, respiratory diseases and dysglycemia were the most common causes of hospitalization.
This nationwide cohort study demonstrated that adolescents with type 2 diabetes mellitus were prone to treatment failure. Furthermore, respiratory diseases and dysglycemia were the most common causes of hospitalization.
We aimed to compare cardiovascular risks among participants with T2DM with and without subsequent HTN and participants with HTN with and without subsequent T2DM.
From January 1, 2000, to December 31, ...2018, we identified 16,236 matched pairs of T2DM participants with and without HTN (T2DM cohorts), 53,509 pairs of HTN participants with and without T2DM (HTN cohorts), and 21,158 pairs of comorbid HTN and T2DM participants with T2DM history or HTN history (comorbid cohorts) from Taiwan's National Health Insurance Research Database. Cox proportional-hazard models were used to calculate the risk of cardiovascular disease.
The mean follow-up time of this study was 6.75 years. Mean incident rates of coronary artery disease for T2DM cohorts, HTN cohorts, and comorbid cohorts were 16.80, 23.18, and 31.53 per 1000 person-years, respectively. The adjusted hazard ratios (HRs) (95% confidence intervals 95% CIs) for incident coronary artery disease, stroke, and heart failure in T2DM participants with versus without HTN were 2.22 (2.07-2.37), 1.19 (1.16-1.23), and 0.92 (0.82-1.02), respectively; the adjusted HRs for HTN participants with versus without T2DM were 1.69 (1.55-1.84), 1.25 (1.21-1.30), and 0.98 (0.93-1.05), respectively; the adjusted HRs for comorbid T2DM and HTN participants with previous T2DM versus previous HTN were 2.78 (2.37-3.27), 1.20 (1.13-1.28), and 0.95 (0.88-1.03), respectively.
This nationwide cohort study demonstrated that both T2DM with subsequent HTN and HTN with subsequent diabetes were associated with higher cardiovascular disease risks.
Background& Aims
Type 2 diabetes mellitus (T2DM) management in patients with cirrhosis is complicated. No clinical trials have investigated appropriate antidiabetic drug use in these patients. This ...study compared the risks of all‐cause mortality, major adverse cardiovascular events (MACE) and hepatic outcomes between patients with T2DM and cirrhosis using and not using thiazolidinedione (TZD).
Methods
We selected 1,705 propensity score–matched TZD users and nonusers from a Taiwan National Health Insurance Research Database cohort of T2DM patients with compensated cirrhosis between January 1, 2000, and December 31, 2012 and followed them until December 31, 2013. Cox proportional hazards models with robust sandwich standard error estimates were used to assess risks of investigated outcomes for TZD users.
Results
MACE incidence rates during follow‐up were 2.14 and 1.30 per 100 patient‐years for TZD users and nonusers, respectively (adjusted hazard ratio aHR 1.70; 95% confidence interval CI, 1.32‐2.19). On the basis of TZD use, the aHRs (95% CIs) for stroke, ischemic heart disease and heart failure were 1.81 (1.28‐2.55), 1.59 (1.03‐2.44) and 2.09 (1.22‐3.60) respectively. Compared with TZD nonusers, rosiglitazone users had significantly higher aHR 1.67 (1.26‐2.20) and pioglitazone users had no significant difference of aHR 1.12 (0.90‐1.64). All‐cause mortality, hepatocellular carcinoma, decompensated cirrhosis and hepatic failure risks did not differ significantly between TZD users and nonusers.
Conclusions
Compared with nonuser, TZD users demonstrated significantly higher MACE risks. Therefore, the risks of cardiovascular complications should be considered when prescribing TZDs to patients with T2DM and cirrhosis.
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