A nationwide cohort study for comparative vascular safety of long-acting insulin analogue versus intermediate-acting human insulin in type 2 diabetes

Abstract Little is known about the comparative vascular safety of basal insulins (intermediate-acting human insulin [IAHI] or long-acting insulin analogue [LAIA]) in type 2 diabetes (T2D). This study sought to examine the vascular and hypoglycemic effects associated with IAHI versus LAIA in real-wor...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Chun-Ting Yang, Kuan-Ying Li, Chen-Yi Yang, Huang-Tz Ou, Shihchen Kuo
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/beb20b4d5d6d4f26815d08506cbc2896
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:beb20b4d5d6d4f26815d08506cbc2896
record_format	dspace
spelling	oai:doaj.org-article:beb20b4d5d6d4f26815d08506cbc28962021-12-02T14:21:59ZA nationwide cohort study for comparative vascular safety of long-acting insulin analogue versus intermediate-acting human insulin in type 2 diabetes10.1038/s41598-021-83253-62045-2322https://doaj.org/article/beb20b4d5d6d4f26815d08506cbc28962021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-83253-6https://doaj.org/toc/2045-2322Abstract Little is known about the comparative vascular safety of basal insulins (intermediate-acting human insulin [IAHI] or long-acting insulin analogue [LAIA]) in type 2 diabetes (T2D). This study sought to examine the vascular and hypoglycemic effects associated with IAHI versus LAIA in real-world patients with T2D. We utilized Taiwan’s National Health Insurance Research Database to identify T2D patients who stably used IAHI (N = 11,521) or LAIA (N = 37,651) in the period 2004–2012. A rigorous three-step matching algorithm that considered the initiation date of basal insulin, previous exposure of antidiabetic treatments, comorbidities, diabetes severity and complications, and concomitant medications was applied to achieve the between-group comparability. Study outcomes, including cardiovascular diseases (CVDs), microvascular diseases (MVDs), and hypoglycemia, were assessed up to the end of 2013. Compared with LAIA, the use of IAHI was associated with greater risks of composite CVDs (adjusted hazard ratio [aHR]: 1.79; 95% confidence interval [CI] 1.20–2.67) and hospitalized hypoglycemia (aHR: 1.82; 95% CI 1.51–2.20), but a lower risk of composite MVDs (aHR: 0.88; 95% CI 0.84–0.91). Subgroup and sensitivity analyses showed a consistent trend of results with that in the primary analyses. In summary, although the use of IAHI versus LAIA among T2D patients in usual practice may be associated with a lower risk of MVDs, strategies should be optimized for minimizing the risks of hypoglycemia and CVDs in this population.Chun-Ting YangKuan-Ying LiChen-Yi YangHuang-Tz OuShihchen KuoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Chun-Ting Yang Kuan-Ying Li Chen-Yi Yang Huang-Tz Ou Shihchen Kuo A nationwide cohort study for comparative vascular safety of long-acting insulin analogue versus intermediate-acting human insulin in type 2 diabetes
description	Abstract Little is known about the comparative vascular safety of basal insulins (intermediate-acting human insulin [IAHI] or long-acting insulin analogue [LAIA]) in type 2 diabetes (T2D). This study sought to examine the vascular and hypoglycemic effects associated with IAHI versus LAIA in real-world patients with T2D. We utilized Taiwan’s National Health Insurance Research Database to identify T2D patients who stably used IAHI (N = 11,521) or LAIA (N = 37,651) in the period 2004–2012. A rigorous three-step matching algorithm that considered the initiation date of basal insulin, previous exposure of antidiabetic treatments, comorbidities, diabetes severity and complications, and concomitant medications was applied to achieve the between-group comparability. Study outcomes, including cardiovascular diseases (CVDs), microvascular diseases (MVDs), and hypoglycemia, were assessed up to the end of 2013. Compared with LAIA, the use of IAHI was associated with greater risks of composite CVDs (adjusted hazard ratio [aHR]: 1.79; 95% confidence interval [CI] 1.20–2.67) and hospitalized hypoglycemia (aHR: 1.82; 95% CI 1.51–2.20), but a lower risk of composite MVDs (aHR: 0.88; 95% CI 0.84–0.91). Subgroup and sensitivity analyses showed a consistent trend of results with that in the primary analyses. In summary, although the use of IAHI versus LAIA among T2D patients in usual practice may be associated with a lower risk of MVDs, strategies should be optimized for minimizing the risks of hypoglycemia and CVDs in this population.
format	article
author	Chun-Ting Yang Kuan-Ying Li Chen-Yi Yang Huang-Tz Ou Shihchen Kuo
author_facet	Chun-Ting Yang Kuan-Ying Li Chen-Yi Yang Huang-Tz Ou Shihchen Kuo
author_sort	Chun-Ting Yang
title	A nationwide cohort study for comparative vascular safety of long-acting insulin analogue versus intermediate-acting human insulin in type 2 diabetes
title_short	A nationwide cohort study for comparative vascular safety of long-acting insulin analogue versus intermediate-acting human insulin in type 2 diabetes
title_full	A nationwide cohort study for comparative vascular safety of long-acting insulin analogue versus intermediate-acting human insulin in type 2 diabetes
title_fullStr	A nationwide cohort study for comparative vascular safety of long-acting insulin analogue versus intermediate-acting human insulin in type 2 diabetes
title_full_unstemmed	A nationwide cohort study for comparative vascular safety of long-acting insulin analogue versus intermediate-acting human insulin in type 2 diabetes
title_sort	nationwide cohort study for comparative vascular safety of long-acting insulin analogue versus intermediate-acting human insulin in type 2 diabetes
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/beb20b4d5d6d4f26815d08506cbc2896
work_keys_str_mv	AT chuntingyang anationwidecohortstudyforcomparativevascularsafetyoflongactinginsulinanalogueversusintermediateactinghumaninsulinintype2diabetes AT kuanyingli anationwidecohortstudyforcomparativevascularsafetyoflongactinginsulinanalogueversusintermediateactinghumaninsulinintype2diabetes AT chenyiyang anationwidecohortstudyforcomparativevascularsafetyoflongactinginsulinanalogueversusintermediateactinghumaninsulinintype2diabetes AT huangtzou anationwidecohortstudyforcomparativevascularsafetyoflongactinginsulinanalogueversusintermediateactinghumaninsulinintype2diabetes AT shihchenkuo anationwidecohortstudyforcomparativevascularsafetyoflongactinginsulinanalogueversusintermediateactinghumaninsulinintype2diabetes AT chuntingyang nationwidecohortstudyforcomparativevascularsafetyoflongactinginsulinanalogueversusintermediateactinghumaninsulinintype2diabetes AT kuanyingli nationwidecohortstudyforcomparativevascularsafetyoflongactinginsulinanalogueversusintermediateactinghumaninsulinintype2diabetes AT chenyiyang nationwidecohortstudyforcomparativevascularsafetyoflongactinginsulinanalogueversusintermediateactinghumaninsulinintype2diabetes AT huangtzou nationwidecohortstudyforcomparativevascularsafetyoflongactinginsulinanalogueversusintermediateactinghumaninsulinintype2diabetes AT shihchenkuo nationwidecohortstudyforcomparativevascularsafetyoflongactinginsulinanalogueversusintermediateactinghumaninsulinintype2diabetes
_version_	1718391512789680128

A nationwide cohort study for comparative vascular safety of long-acting insulin analogue versus intermediate-acting human insulin in type 2 diabetes

Ejemplares similares