Within-Sulfonylurea-Class Evaluation of Time to Intensification with Insulin (ZODIAC-43)

Previous studies have shown that many within-class differences exist between sulfonylureas (SUs), however, whether differences exist regarding the time it takes between initiating an SU and the need to intensify treatment with insulin is unclear. The aim of this study was investigate the relationshi...

Full description

Saved in:
Bibliographic Details
Published in:PloS one 2016-06, Vol.11 (6), p.e0157668-e0157668
Main Authors: Schrijnders, Dennis, Hartog, Laura C, Kleefstra, Nanne, Groenier, Klaas H, Landman, Gijs W D, Bilo, Henk J G
Format: Article
Language:English
Subjects:
Amplification
Analysis
Biology and Life Sciences
Cohort analysis
Complications and side effects
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - drug therapy
Diabetes therapy
Dosage and administration
Drug interactions
Endpoint Determination
Epidemiology
Female
Glucose
Health care
Hemoglobin
Humans
Insulin
Insulin - therapeutic use
Internal medicine
Male
Medical research
Medicine
Medicine and Health Sciences
Metformin
Middle Aged
Patients
People and Places
Physiological aspects
Proportional Hazards Models
Research and Analysis Methods
Statistical analysis
Statistical models
Studies
Sulfonylurea
Sulfonylurea Compounds - therapeutic use
Sulfonylureas
Survival Analysis
Systematic review
Therapy
Time Factors
Tolbutamide
Zodiac
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Previous studies have shown that many within-class differences exist between sulfonylureas (SUs), however, whether differences exist regarding the time it takes between initiating an SU and the need to intensify treatment with insulin is unclear. The aim of this study was investigate the relationships between the three frequently used sulphonylureas, prescribed as dual therapy next to metformin, and the time needed to treatment intensification with either insulin or oral triple therapy in patients with type 2 diabetes mellitus. Zwolle Outpatient Diabetes project Integrating Available Care (ZODIAC) is a prospective observational cohort study set in primary care in the Netherlands. Annually collected data on diabetes medication and clinical variables within ZODIAC are used to evaluate the primary outcome, time to insulin and secondary outcome, time to either insulin or triple oral therapy. For statistical analysis a time-dependent cox proportional hazard model was used. 3507 patients were included in the analysis, with a mean age of 61 (SD 11.4) and a median HbA1c of 6.8% [IQR 6.4-7.4] (50.8 mmol/mol [IQR 46.4-57.4]).The hazard ratio (HR) for the primary endpoint was 1.10 (95% CI 0.78-1.54) for metformin/glimepiride and 0.93 (95% CI 0.67-1.30) for metformin/tolbutamide with metformin/gliclazide as reference group. The HR for the secondary outcome was 1.04 (95% CI 0.78-1.40) and 0.85 (95% CI 0.64-1.13), respectively. In this large Dutch primary care cohort, new users of neither gliclazide, glimepiride nor tolbutamide as dual therapy with metformin, resulted in differences in the time needed for further treatment intensification.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0157668