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1 Congestive heart failure (presumably secondary to associated liver dysfunction), MI, and cerebrovascular accidents were major risk factors for severe hypoglycemia during sulfonylurea therapy. The incidence rates of HHF among sulphonylureas initiators and acarbose initiators were 22.2 (95% CI 19.6‐24.9) and 18.3 (95% CI 13.2‐24.9) per 1000 person‐years, respectively.
A recent study presented by DCRI researchers at the annual American Heart Association (AHA) conference in Anaheim, California, aimed to evaluate the relative effectiveness of … Methods: Retrospective cohort study of all adults without HF newly treated with oral antidiabetic drugs in Saskatchewan, Canada between 1991 and 1999. We’re hoping our study helps build a case for that.”In addition to DeVore, other researchers included Abhinav Sharma, Adrian F. Hernandez, Joseph Lucas and G. Michael Felker. doi: 10.1016/j.ejheart.2008.05.013.
The adjusted hazard ratio (aHR) of HHF for sulphonylureas vs acarbose was 1.61 (95% CI 1.14‐2.27). New users were defined as patients who filled a first hypoglycemic prescription between January 1, 2010 and September 20, 2016 with at least 1 year of baseline history and without any anti‐diabetic medication filled in the 180 days before the first fill.Rx, prescription; YRHCD, Yinzhou Regional Health Care Database.A, keeps the latency period constant at 90 days; B, keeps the induction period constant at 90 daysCI, Confidence Interval; HR, Hazard Ratio; IQR, interquartile rangeCI, Confidence Interval; HR, Hazard Ratio; IQR, interquartile range.CI, Confidence Interval; HR, Hazard Ratio; IQR, interquartile range.Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Diabetes Obes Metab. © 2020 Duke University and Duke University Health System, All rights reserved This review will thus provide guidance for future studies on the use of robust methods to minimize bias in assessing the cardiovascular safety of newer antidiabetic drugs.A MEDLINE search was conducted to identify all observational studies assessing the effects of sulfonylureas on the incidence of cardiovascular and cerebrovascular events, cardiovascular mortality, and all-cause mortality.
Although most observational studies accomplish this quite well within the limitations of the available data, there are other sources of bias that can arise in their study design, which can have a greater impact on their results.
Thus, in contrast with RCTs where such comparability is inherently established by randomization, observational studies must rely on matching or statistical adjustment techniques to minimize the potential for confounding bias and determine comparability. In addition, we discuss the role of the comparator used in these studies.A meta-regression analysis was used to evaluate the heterogeneity among the relative risks. First, given the progressive nature of type 2 diabetes, the primary exposure definition should be based on an as-treated approach or modeling exposure as a time-varying variable. 2020 Jun 29;8(7):182. doi: 10.3390/biomedicines8070182.J Am Heart Assoc.
Patients with impaired liver and/or renal function treated with sulfonylureas may be exposed to higher serum drug concentrations, which can increase the potential for severe hypoglycemic episodes induced by these agents. Each study was appraised with respect to the comparator, the outcome, and study design–related sources of bias. Sulfonylureas stimulate the beta cells of the pancreas to release more insulin. Indeed, any study evaluating the risk of sulfonylureas will have to ensure that the comparator group of patients is practically identical to the patients using sulfonylureas. We do not capture any email address.Meinert CL, Knatterud GL, Prout TE, Klimt CR. II.
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