| アブストラクト | AIM: To investigate the effect of dipeptidyl peptidase-4 inhibitors (DPP4-Is) and glucagon-like peptide-1 receptor agonists (GLP1-RAs) on diabetic foot ulcer (DFU) and DFU-related outcomes (lower limb amputation [LLA], DFU-related hospitalization and mortality). METHODS: We performed a cohort study with data from the Clinical Practice Research Datalink Aurum database with linkage to hospital data. We included people with type 2 diabetes starting treatment with metformin. Then we propensity score matched new users of DPP4-Is and sulphonylureas (N = 98 770), and new users of GLP1-RAs and insulin (N = 25 422). Cox proportional hazards models estimated the hazard ratios (HRs) for the outcomes. RESULTS: We observed a lower risk of DFU with both DPP4-I use versus sulphonylurea use (HR 0.88, 95% confidence interval [CI]: 0.79-0.97) and GLP1-RA use versus insulin use (HR 0.44, 95% CI: 0.32-0.60) for short-term exposure (</= 400 days) and HR 0.74 (95% CI: 0.60-0.92) for long-term exposure (>400 days). Furthermore, the risks of hospitalization and mortality were lower with both DPP4-I use and GLP1-RA use. The risk of LLA was lower with GLP1-RA use. The results remained consistent across several sensitivity analyses. CONCLUSIONS: Incretin-based therapy was associated with a lower risk of DFU and DFU-related outcomes. This suggests benefits for the use of this treatment in people at risk of DFU. |
|---|
| ジャーナル名 | Diabetes, obesity & metabolism |
|---|
| 投稿日 | 2024/7/2 |
|---|
| 投稿者 | Werkman, Nikki C C; Driessen, Johanna H M; Klungel, Olaf H; Schaper, Nicolaas S; Souverein, Patrick C; Stehouwer, Coen D A; Nielen, Johannes T H |
|---|
| 組織名 | Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of;Pharmaceutical Sciences, Utrecht, The Netherlands.;Department of Clinical Pharmacy & Toxicology, Maastricht University Medical;Center+, Maastricht, The Netherlands.;Cardiovascular Research Institute Maastricht (CARIM), Maastricht University,;Maastricht, The Netherlands.;Department of Internal Medicine, Division of Endocrinology, Maastricht University;Medical Center+, Maastricht, The Netherlands.;Department of Internal Medicine, Maastricht University Medical Center+, |
|---|
| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/38951877/ |
|---|
