アブストラクト | AIMS: Hypoglycaemia in patients with diabetes can be induced by insulins and sulfonylureas. We assessed the real-world impact of specific monotherapy and combination regimens on hypoglycaemic events requiring hospitalisation and related secondary costs to the English healthcare system. METHODS: This retrospective observational study used the Clinical Practice Research Datalink with linked hospital admission data during 2008-2012. Patients with type 2 diabetes mellitus (T2DM) using antihyperglycaemic agents (AHAs) were assigned to mutually exclusive subgroups (insulin- and non-insulin-containing regimens; treatment groups of interest; age group) based on treatment at index date (date of first AHA prescription). Outcomes were number and cost of hospital admissions with hypoglycaemic event-related diagnosis codes. RESULTS: We identified 110 206 patients with T2DM (mean age 64.9 years, time since diagnosis 5.4 years, HbA1c at index 7.4%), with 439 hypoglycaemic events requiring inpatient hospitalisation (mean length of stay 6.3 days, mean cost/stay pound1351). Event rates and cost of stay were highest in patients treated with sulfonylurea- or insulin-based regimens. Event rates, duration and cost of stay were higher in older patients. CONCLUSION: Rates of severe hypoglycaemic events varied substantially between T2DM regimens. In this study of patients treated in clinical practice in England, sulfonylurea- and insulin-based regimens were associated with the highest event rates and costs associated with hospitalisation for severe hypoglycaemic events; hospitalisation for severe hypoglycaemic events was not observed with dipeptidyl peptidase-4 inhibitor monotherapy or with metformin. |
ジャーナル名 | International journal of clinical practice |
投稿日 | 2017/5/26 |
投稿者 | Holbrook, Tim; Tang, Yuexin; Das, Romita; Shankar, R Ravi; Tunceli, Kaan; Williams, Jean; Radican, Larry; Holden, Sarah E; Morgan, Chris Ll; Piercy, James; Currie, Craig J |
組織名 | Adelphi Real World, Manchester, UK.;MRL, Merck & Co., Inc., Kenilworth, NJ, USA.;HTA and Observational Research, MSD Ltd, Hoddesdon, UK.;Pharmatelligence, Cardiff, UK.;Cardiff University, Cardiff, UK. |
Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/28544081/ |