Can people with type 2 diabetes live longer than those without? A comparison of mortality in people initiated with metformin or sulphonylurea monotherapy and matched, non-diabetic controls.

摘要: Aims: Clinical and observational studies have demonstrated increased risk of cardiovascular events death associated with sulfonylureas versus metformin. However, it has never been determined whether this was due to the beneficial effects metformin or detrimental sulfonylureas. Our objective therefore compare all-cause mortality in diabetic patients treated first-line, glucose lowering therapy either sulfonylurea monotherapy that matched individuals without diabetes. Materials Methods: We used retrospective data from UK Clinical Practice Research Datalink (CPRD) 2000. Subjects type 2 diabetes who progressed first-line treatment were selected people diabetes. Progression compared using parametric survival models included a range relevant co-variables. Results: We identified 78,241 subjects metformin, 12,222 sulfonylurea, 90,463 cases This resulted total, censored follow-up period 503,384 years. There 7,498 deaths representing unadjusted rates 14.4 15.2, 50.9 28.7 per 1,000 person-years for their controls, respectively. With reference observed initiated monotherapy, adjusted median time 15% lower (survival ratio = 0.85, 95%CI 0.81–0.90) than diabetes, reduced by 38% ratio = 0.62, 0.58–0.66) monotherapy. Conclusions: Patients had longer did matched, non-diabetic controls. Those markedly both controls those receiving monotherapy. supports position as implies may confer benefit non-diabetes. Sulfonylurea remains continued concern.