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| Title: | Meglitinides increase the risk of hypoglycemia in diabetic patients with advanced chronic kidney disease: A nationwide, population-based study |
| Authors: | Wu, PC;Wu, VC;Lin, CJ;Pan, CF;Chen, CY;Huang, TM;Wu, CH;Chen, L;Wu, CJ;Consortium, The NRPB Kidney |
| Contributors: | Division of Health Services and Preventive Medicine |
| Abstract: | The safety of short-acting meglitinides in diabetic patients with advanced chronic kidney disease (CKD) has not been widely reported.Diabetic patients with advanced CKD who had a serum creatinine level of > 6 mg/dL a hematocrit level of <== 28% and received erythropoiesis-stimulating agent treatment between 2000 and 2010, were included in this nationwide study in Taiwan.The outcomes of interest were defined as hypoglycemia and long-term mortality. The risks of hypoglycemia and death were analyzed using Cox proportional hazards models, with end-stage renal disease and anti-diabetic drugs as time-dependent variables.Fresh users and matched non-users of meglitinides (both n = 2,793) were analyzed. The use of meglitinides increased the risk of hypoglycemia (HR, 1.93; 95% CI, 1.56-2.39), as did sulfonylurea and insulin use. The hypoglycemic effect of meglitinides was consistent among patient subgroups stratified by the status of concomitant use of other oral anti-diabetic agents. Concomitant use of meglitinide and insuilin will incresase the hypoglycemic risk. Moreover, it was not the use of meglitinides, but the presence of hypoglycemia that predicted mortality. The function curve showed an insignificant trend towards increased hypoglycemic risk in patients aged > 62 and </= 33 years from the generalized additive model.This study suggests that the use of short-acting meglitinides could be associated with increased risk of hypoglycemia in diabetic patients with advanced CKD, especially in patients aged > 62 and </= 33 years. Meglitinide combined with insulin will increase hypoglycemia in patients with advanced CKD. |
| Date: | 2017-09 |
| Relation: | Oncotarget. 2017 Sep;8(44):78086-78095. |
| Link to: | https://doi.org/10.18632/oncotarget.17475 |
| Cited Times(WOS): | https://www.webofscience.com/wos/woscc/full-record/WOS:000412066700183 |
| Cited Times(Scopus): | https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85030309241 |
| Appears in Collections: | [陳麗光] 期刊論文
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