Cardiovascular outcomes of dipeptidyl peptidase-4 inhibitors in patients with type 2 diabetes on insulin therapy. (June 2018)

• Record Type: Journal Article
• Authors: Yen, Fu-Shun; Chiang, Jen-Huai; Pan, Chun-Wei; Lin, Boniface J.; Wei, James Cheng-Chung; Hsu, Chih-Cheng
• Is Part Of: Diabetes research and clinical practice. Volume 140(2018)
• Page Start: 279
• Page End: 287
• Publication Date: 2018-06
• Subjects: Stroke -- DPP-4 inhibitors -- Type 2 diabetes mellitus; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2018.04.012
• Languages: English
• ISSNs: 0168-8227

Abstract

Abstract: Aims: To compare the hazard of cardiovascular diseases between DPP-4 inhibitor users and non-users who were on insulin therapy. Methods: We conducted a population-based cohort study. 2652 patients with type 2 diabetes mellitus (T2DM) under insulin therapy were enrolled during 1997–2010. The incidence rates per 1000 person-years (PYs) of stroke, coronary heart disease (CAD) and heart failure were compared between 1326 DPP-4 inhibitor users and 1326 propensity score matched non-users. Multivariable Cox proportional hazards model was used to evaluate excess risk of the DPP-4 inhibitor non-users. Results: After adjustment of age, gender, comorbidities, drugs used and diabetes duration; the incidence rate per 1000 PYs were 21.70 and 9.88 in DPP-4 inhibitor non-users and users; DPP-4 inhibitor users had lower hazard ratio (HR) of stroke (adjusted HR: 0.59, 95% CI: 0.42–0.83, p value: 0.002) compared with non-users. The incidence rates per 1000 PYs of CAD and heart failure of control versus users were 19.85 versus 13.54 and 5.56 versus 4.78; the adjusted HRs of CAD and heart failure were 0.86 and 1.11. Both were non-significant. Conclusion: This nationwide study demonstrated that insulin plus DPP-4 inhibitor users had significantly lower risk of stroke as compared with non-users.