Lower rate of cardiovascular complications in patients on bolus insulin analogues: a retrospective population-based cohort study.
<h4>Background</h4>Few studies are available evaluating the impact of rapid-acting insulin analogues on long-term diabetes outcomes. Our aim was to compare the use of rapid-acting insulin analogues versus human regular insulin in relation to the occurrence of diabetic complications in a...
Guardado en:
| Autores principales: | , , , , , , , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Public Library of Science (PLoS)
2013
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/e541f3903b574bb9b3cb341fff5e1d9b |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:e541f3903b574bb9b3cb341fff5e1d9b |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:e541f3903b574bb9b3cb341fff5e1d9b2021-11-18T08:47:52ZLower rate of cardiovascular complications in patients on bolus insulin analogues: a retrospective population-based cohort study.1932-620310.1371/journal.pone.0079762https://doaj.org/article/e541f3903b574bb9b3cb341fff5e1d9b2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24244557/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Few studies are available evaluating the impact of rapid-acting insulin analogues on long-term diabetes outcomes. Our aim was to compare the use of rapid-acting insulin analogues versus human regular insulin in relation to the occurrence of diabetic complications in a cohort of diabetic patients through the analysis of administrative databases.<h4>Methods</h4>A population-based cohort study was conducted using administrative data from four local health authorities in the Abruzzo Region (900,000 inhabitants). Diabetic patients free of macrovascular disease at baseline and treated either with human regular insulin or rapid-acting insulin analogues were followed for a maximum of 3 years. The incidence of diabetic complications was ascertained by hospital discharge claims. Hazard ratios (HRs) and 95% CIs of any diabetic complication and macrovascular, microvascular and metabolic complications were estimated separately using Cox proportional hazard models adjusted for patients' characteristics and anti-diabetic drug use. Propensity score matching was also used to adjust for significant difference in the baseline characteristics between the two treatment groups.<h4>Results</h4>A total of 2,286 patients were included: 914 receiving human regular insulin and 1,372 rapid-acting insulin analogues. During the follow-up, 286 (31.3%) incident events occurred in the human regular insulin group and 235 (17.1%) in the rapid-acting insulin analogue group. After propensity score-based matched-pair analyses, rapid-acting insulin analogues users had a HR of 0.73 (0.58-0.92) for any diabetes-related complication and HRs of 0.73 (0.55-0.93) and 0.55 (0.32-0.96) for macrovascular and metabolic complications respectively, as compared with human regular insulin users. No difference between the two groups was found for microvascular complications.<h4>Conclusions</h4>Our findings suggest that the use of rapid-acting insulin analogues is associated with a lower risk of cardiovascular and metabolic complications compared with human regular insulin use.Simona CammarotaLucio Marcello FalconioDario BruzzeseAlberico Luigi CatapanoManuela CasulaAnna CitarellaLuigi De LucaMaria Elena FlaccoLamberto ManzoliMaria MasulliEnrica MendittoAndrea MezzettiSalvatore RieglerEttore NovellinoGabriele RiccardiPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 11, p e79762 (2013) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Simona Cammarota Lucio Marcello Falconio Dario Bruzzese Alberico Luigi Catapano Manuela Casula Anna Citarella Luigi De Luca Maria Elena Flacco Lamberto Manzoli Maria Masulli Enrica Menditto Andrea Mezzetti Salvatore Riegler Ettore Novellino Gabriele Riccardi Lower rate of cardiovascular complications in patients on bolus insulin analogues: a retrospective population-based cohort study. |
| description |
<h4>Background</h4>Few studies are available evaluating the impact of rapid-acting insulin analogues on long-term diabetes outcomes. Our aim was to compare the use of rapid-acting insulin analogues versus human regular insulin in relation to the occurrence of diabetic complications in a cohort of diabetic patients through the analysis of administrative databases.<h4>Methods</h4>A population-based cohort study was conducted using administrative data from four local health authorities in the Abruzzo Region (900,000 inhabitants). Diabetic patients free of macrovascular disease at baseline and treated either with human regular insulin or rapid-acting insulin analogues were followed for a maximum of 3 years. The incidence of diabetic complications was ascertained by hospital discharge claims. Hazard ratios (HRs) and 95% CIs of any diabetic complication and macrovascular, microvascular and metabolic complications were estimated separately using Cox proportional hazard models adjusted for patients' characteristics and anti-diabetic drug use. Propensity score matching was also used to adjust for significant difference in the baseline characteristics between the two treatment groups.<h4>Results</h4>A total of 2,286 patients were included: 914 receiving human regular insulin and 1,372 rapid-acting insulin analogues. During the follow-up, 286 (31.3%) incident events occurred in the human regular insulin group and 235 (17.1%) in the rapid-acting insulin analogue group. After propensity score-based matched-pair analyses, rapid-acting insulin analogues users had a HR of 0.73 (0.58-0.92) for any diabetes-related complication and HRs of 0.73 (0.55-0.93) and 0.55 (0.32-0.96) for macrovascular and metabolic complications respectively, as compared with human regular insulin users. No difference between the two groups was found for microvascular complications.<h4>Conclusions</h4>Our findings suggest that the use of rapid-acting insulin analogues is associated with a lower risk of cardiovascular and metabolic complications compared with human regular insulin use. |
| format |
article |
| author |
Simona Cammarota Lucio Marcello Falconio Dario Bruzzese Alberico Luigi Catapano Manuela Casula Anna Citarella Luigi De Luca Maria Elena Flacco Lamberto Manzoli Maria Masulli Enrica Menditto Andrea Mezzetti Salvatore Riegler Ettore Novellino Gabriele Riccardi |
| author_facet |
Simona Cammarota Lucio Marcello Falconio Dario Bruzzese Alberico Luigi Catapano Manuela Casula Anna Citarella Luigi De Luca Maria Elena Flacco Lamberto Manzoli Maria Masulli Enrica Menditto Andrea Mezzetti Salvatore Riegler Ettore Novellino Gabriele Riccardi |
| author_sort |
Simona Cammarota |
| title |
Lower rate of cardiovascular complications in patients on bolus insulin analogues: a retrospective population-based cohort study. |
| title_short |
Lower rate of cardiovascular complications in patients on bolus insulin analogues: a retrospective population-based cohort study. |
| title_full |
Lower rate of cardiovascular complications in patients on bolus insulin analogues: a retrospective population-based cohort study. |
| title_fullStr |
Lower rate of cardiovascular complications in patients on bolus insulin analogues: a retrospective population-based cohort study. |
| title_full_unstemmed |
Lower rate of cardiovascular complications in patients on bolus insulin analogues: a retrospective population-based cohort study. |
| title_sort |
lower rate of cardiovascular complications in patients on bolus insulin analogues: a retrospective population-based cohort study. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2013 |
| url |
https://doaj.org/article/e541f3903b574bb9b3cb341fff5e1d9b |
| work_keys_str_mv |
AT simonacammarota lowerrateofcardiovascularcomplicationsinpatientsonbolusinsulinanaloguesaretrospectivepopulationbasedcohortstudy AT luciomarcellofalconio lowerrateofcardiovascularcomplicationsinpatientsonbolusinsulinanaloguesaretrospectivepopulationbasedcohortstudy AT dariobruzzese lowerrateofcardiovascularcomplicationsinpatientsonbolusinsulinanaloguesaretrospectivepopulationbasedcohortstudy AT albericoluigicatapano lowerrateofcardiovascularcomplicationsinpatientsonbolusinsulinanaloguesaretrospectivepopulationbasedcohortstudy AT manuelacasula lowerrateofcardiovascularcomplicationsinpatientsonbolusinsulinanaloguesaretrospectivepopulationbasedcohortstudy AT annacitarella lowerrateofcardiovascularcomplicationsinpatientsonbolusinsulinanaloguesaretrospectivepopulationbasedcohortstudy AT luigideluca lowerrateofcardiovascularcomplicationsinpatientsonbolusinsulinanaloguesaretrospectivepopulationbasedcohortstudy AT mariaelenaflacco lowerrateofcardiovascularcomplicationsinpatientsonbolusinsulinanaloguesaretrospectivepopulationbasedcohortstudy AT lambertomanzoli lowerrateofcardiovascularcomplicationsinpatientsonbolusinsulinanaloguesaretrospectivepopulationbasedcohortstudy AT mariamasulli lowerrateofcardiovascularcomplicationsinpatientsonbolusinsulinanaloguesaretrospectivepopulationbasedcohortstudy AT enricamenditto lowerrateofcardiovascularcomplicationsinpatientsonbolusinsulinanaloguesaretrospectivepopulationbasedcohortstudy AT andreamezzetti lowerrateofcardiovascularcomplicationsinpatientsonbolusinsulinanaloguesaretrospectivepopulationbasedcohortstudy AT salvatoreriegler lowerrateofcardiovascularcomplicationsinpatientsonbolusinsulinanaloguesaretrospectivepopulationbasedcohortstudy AT ettorenovellino lowerrateofcardiovascularcomplicationsinpatientsonbolusinsulinanaloguesaretrospectivepopulationbasedcohortstudy AT gabrielericcardi lowerrateofcardiovascularcomplicationsinpatientsonbolusinsulinanaloguesaretrospectivepopulationbasedcohortstudy |
| _version_ |
1718421293616857088 |