| Title |
Hypoglycemia hospitalization frequency in patients with type 2 diabetes mellitus: a comparison of dipeptidyl peptidase 4 inhibitors and insulin secretagogues using the French health insurance database
|
|---|---|
| Published in |
Vascular Health and Risk Management, July 2015
|
| DOI | 10.2147/vhrm.s84507 |
| Pubmed ID | |
| Authors |
Bruno Detournay, Serge Halimi, Julien Robert, Céline Deschaseaux, Sylvie Dejager |
| Abstract |
We aimed to compare the frequency of severe hypoglycemia leading to hospitalization (HH) and emergency visits (EV) for any cause in patients with type 2 diabetes mellitus exposed to dipeptidyl peptidase 4 (DPP4) inhibitors (DPP4-i) versus those exposed to insulin secretagogues (IS; sulfonylureas or glinides). Data were extracted from the EGB (Echantillon Généraliste des Bénéficiaires) database, comprising a representative sample of ~1% of patients registered in the French National Health Insurance System (~600,000 patients). Type 2 diabetes mellitus patients exposed to regimens containing either a DPP4-i (excluding treatment with IS, insulin, or glucagon-like peptide 1 analog) or IS (excluding treatment with insulin and any incretin therapy) between 2009 and 2012 were selected. HH and EV during the exposure periods were identified in both cohorts. A similar analysis was conducted considering vildagliptin alone versus IS. Comparative analyses adjusting for covariates within the model (subjects matched for key characteristics) and using multinomial regression models were performed. Overall, 7,152 patients exposed to any DPP4-i and 1,440 patients exposed to vildagliptin were compared to 10,019 patients exposed to IS. Eight patients (0.11%) from the DPP4-i cohort and none from the vildagliptin cohort (0.0%) were hospitalized for hypoglycemia versus 130 patients (1.30%) from the IS cohort (138 hospitalizations) (P=0.02 and P<0.0001, respectively). Crude rates of HH/1,000 patient-years were 1.4 (95% CI: 0.7; 2.4) in the DPP4-i cohort, 0.0 in the vildagliptin cohort (95% CI: 0.0; 4.0), versus 5.6 (95% CI, 4.7; 6.6) in the IS cohort (P<0.0001). After adjustments, rates per 1,000 patient-years of HH were 1.4 (95% CI: 0.7; 2.4) with DPP4-i versus 7.5 (95% CI: 6.0; 9.2) with IS (P<0.0001), and 0.0 (95% CI: 0.0; 4.0) with vildagliptin versus 13.6 (95% CI: 10.4; 17.5) with IS (P<0.0001). Adjusted EV rates were also significantly lower with all DPP4-i or with vildagliptin, as compared to IS (P<0.0001). Consistent results were found when considering only treatment initiations for all compared cohorts. HH and EV were significantly less frequent in patients exposed to any DPP4-i or to vildagliptin versus IS. These real-life data should be considered in the benefit/risk evaluation of the drugs. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 14% |
| Canada | 1 | 14% |
| Unknown | 5 | 71% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 3 | 43% |
| Practitioners (doctors, other healthcare professionals) | 3 | 43% |
| Scientists | 1 | 14% |
Mendeley readers
The data shown below were compiled from readership statistics for 36 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 3% |
| Brazil | 1 | 3% |
| Unknown | 34 | 94% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 10 | 28% |
| Researcher | 7 | 19% |
| Student > Ph. D. Student | 6 | 17% |
| Student > Doctoral Student | 2 | 6% |
| Student > Bachelor | 2 | 6% |
| Other | 4 | 11% |
| Unknown | 5 | 14% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 17 | 47% |
| Agricultural and Biological Sciences | 4 | 11% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 6% |
| Business, Management and Accounting | 1 | 3% |
| Nursing and Health Professions | 1 | 3% |
| Other | 5 | 14% |
| Unknown | 6 | 17% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 26 April 2016.
All research outputs
#8,618,954
of 25,584,565 outputs
Outputs from Vascular Health and Risk Management
#302
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Outputs of similar age
#95,431
of 277,879 outputs
Outputs of similar age from Vascular Health and Risk Management
#13
of 25 outputs
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So far Altmetric has tracked 785 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.5. This one is in the 48th percentile – i.e., 48% of its peers scored the same or lower than it.
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