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Comparing kidney outcomes in type 2 diabetes treated with different sulphonylureas in real-life clinical practice

Authors
 Y.-h. Lee  ;  C.J. Lee  ;  H.S. Lee  ;  E.Y. Choe  ;  B.-W. Lee  ;  C.W. Ahn  ;  B.-S. Cha  ;  H.C. Lee  ;  B. Balkau  ;  E.S. Kang 
Citation
 Diabetes & Metabolism, Vol.41(3) : 208-215, 2015 
Journal Title
 Diabetes & Metabolism 
ISSN
 1262-3636 
Issue Date
2015
Abstract
AIM: Although several sulphonylureas are widely used in type 2 diabetes (T2D), their differential impacts on long-term major kidney outcomes remain unclear. This study aimed to investigate the effects of the two most commonly prescribed sulphonylureas, glimepiride and gliclazide, on kidney outcomes in patients with T2D. METHODS: A total of 4486 patients treated with either glimepiride or gliclazide for more than 2 years were followed for up to 5.5 years (median: 4.7 years). A propensity score based on baseline characteristics was used to match 1427 patients treated with glimepiride with 1427 gliclazide-treated patients; incidences of end-stage renal disease (ESRD) and sustained doubling of creatinine to>132.6 μmol/L (1.5mg/dL) were also compared. RESULTS: In the matched cohort with 12,122 person-years of follow-up, there was no significant difference between groups in risk of ESRD [hazard ratio (HR): 0.57, 95% confidence interval (CI): 0.29-1.12] or doubling of creatinine (HR: 0.74, 95% CI: 0.44-1.26), although there was a trend towards higher risks in the glimepiride group. Subgroup analyses showed that, compared with glimepiride, gliclazide was associated with a lower risk of doubling of creatinine in patients with preserved renal function (glomerular filtration rate ≥ 60 mL/min/1.73 m(2), HR: 0.21, 95% CI: 0.04-0.99) and good glycaemic control (HbA1c < 7%, HR: 0.35, 95% CI: 0.14-0.86), and in older subjects (≥ 62 years, HR: 0.52, 95% CI: 0.27-0.99). CONCLUSION: In a real-life setting, there was no significant difference in clinical outcomes of kidney disease for patients treated with glimepiride vs gliclazide. However, gliclazide appeared to protect against renal complication progression in certain populations.
Full Text
http://www.em-consulte.com/article/981035/alertePM
DOI
10.1016/j.diabet.2015.01.004
Appears in Collections:
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
강은석(Kang, Eun Seok) ORCID logo https://orcid.org/0000-0002-0364-4675
안철우(Ahn, Chul Woo) ORCID logo https://orcid.org/0000-0003-3733-7486
이병완(Lee, Byung Wan) ORCID logo https://orcid.org/0000-0002-9899-4992
이용호(Lee, Yong Ho) ORCID logo https://orcid.org/0000-0002-6219-4942
이찬주(Lee, Chan Joo) ORCID logo https://orcid.org/0000-0002-8756-409X
이현철(Lee, Hyun Chul)
이혜선(Lee, Hye Sun) ORCID logo https://orcid.org/0000-0001-6328-6948
차봉수(Cha, Bong Soo) ORCID logo https://orcid.org/0000-0003-0542-2854
최은영(Choe, Eun Yeong)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/140328
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